What question did this study set out to answer?

Investigate anticoagulation management strategies and compare bleeding and thromboembolic complications between argatroban and bivalirudin in patients on continuous renal replacement therapy with suspected heparin-induced thrombocytopenia.

January 1, 2019Clinical Medicine Insights Trauma and Intensive MedicineOpen Access

Evaluation of the Use of Argatroban or Bivalirudin for the Management of Suspected Heparin-Induced Thrombocytopenia in the Setting of Continuous Renal Replacement Therapy

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Authors

TCTyler ChanasVidant Medical Center SPSurabhi PalkimasUniversity of Montana HMHillary S. MaitlandUniversity of Virginia

Discussion

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Implication

Retrospective study observes similar bleeding and clotting rates between argatroban and bivalirudin in CRRT patients with suspected HIT, suggesting both are viable alternative anticoagulants.

Key Points

Investigate anticoagulation management strategies and compare bleeding and thromboembolic complications between argatroban and bivalirudin in patients on continuous renal replacement therapy with suspected heparin-induced thrombocytopenia.
Retrospective study of 74 patients receiving continuous renal replacement therapy with suspected heparin-induced thrombocytopenia between January 2013 and December 2015.
Evaluated dosing, time to reach therapeutic range, activated partial thromboplastin time (aPTT) target attainment, major bleeding, and thromboembolic events between argatroban (n = 20) and bivalirudin (n = 18).
Time to therapeutic range was 17.6 hours for argatroban versus 18.2 hours for bivalirudin (P = .485), but argatroban resulted in significantly more therapeutic aPTT values (54.5% vs 42.8%, P = .008).
Major bleeding occurred in 20.0% (4/20) of patients receiving argatroban compared with 27.8% (5/18) receiving bivalirudin (P = .709).
Thromboembolic events occurred in 15.0% (3/20) of patients in the argatroban group versus 22.2% (4/18) in the bivalirudin group (P = .687).

Cite This Study

Chanas et al. (2019) studied this question.

synapsesocial.com/papers/6a8733dd713eb98b40ca2e95 https://doi.org/10.1177/1179560319846452

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Implication

Retrospective study observes similar bleeding and clotting rates between argatroban and bivalirudin in CRRT patients with suspected HIT, suggesting both are viable alternative anticoagulants.

Evaluation of the Use of Argatroban or Bivalirudin for the Management of Suspected Heparin-Induced Thrombocytopenia in the Setting of Continuous Renal Replacement Therapy

Discussion

Member takes

Implication

Key Points

Cite This Study

Evaluation of the Use of Argatroban or Bivalirudin for the Management of Suspected Heparin-Induced Thrombocytopenia in the Setting of Continuous Renal Replacement Therapy

Discussion

Member takes

Implication

Key Points

Cite This Study

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