Argatroban management in pediatric patients on extracorporeal support undergoing heart transplantation presents significant clinical challenges, including risks of circuit thrombosis and massive hemorrhage.
Risks of thrombosis and hemorrhage warrant caution with argatroban in pediatric heart transplant on bypass; leaves optimal strategies open.
A 6-year-old child developed heparin-induced thrombocytopenia while on extracorporeal life support. Hours after a difficult transition from heparin to argatroban for anticoagulation therapy, the child underwent heart transplantation. Intraoperative management was plagued with circuit thrombus formation while on cardiopulmonary bypass and subsequent massive hemorrhage after bypass. We review the child's anticoagulation management, clinical challenges encountered, and review current literature related to the use of argatroban in pediatric cardiac surgery.
No takes yet. Share an insight, caveat, or question.
Latham et al. (2015) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: