Argatroban as an alternative to heparin in extracorporeal membrane oxygenation circuits
| Autor: | Guy Young, Peggy Nakagawa, Karyn E Yonekawa, Diane J. Nugent |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
0301 basic medicine
medicine.drug_class medicine.medical_treatment 030204 cardiovascular system & hematology Arginine Argatroban 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation medicine Extracorporeal membrane oxygenation Thromboplastin Humans Radiology Nuclear Medicine and imaging Blood coagulation test Advanced and Specialized Nursing Sulfonamides medicine.diagnostic_test business.industry Heparin Anticoagulant Thrombin Thrombosis General Medicine Thromboelastography Thrombelastography 030104 developmental biology Direct thrombin inhibitor Anesthesia Pipecolic Acids Equipment Failure Blood Coagulation Tests Cardiology and Cardiovascular Medicine business Safety Research Biomarkers circulatory and respiratory physiology medicine.drug |
| Zdroj: | Perfusion. 19(5) |
| ISSN: | 0267-6591 |
| Popis: | We investigated the anticoagulant effects of argatroban, a direct thrombin inhibitor, versus heparin in extracorporeal membrane oxygenation (ECMO) circuits. Three sham circuits were prepared according to our hospital’s standard practice and run for six hours simultaneously. Two circuits were anticoagulated with argatroban (one with heparin in the wet prime and one without). One circuit had heparin in the initial prime and was then anticoagulated with heparin. We measured thrombin generation (prothrombin fragment 1+2, D-dimer and thrombin-antithrombin complexes), activated clotting times (ACTs) and partial thromboplastin times (aPTTs), and monitored thrombus formation using thromboelastography. ACTs were >1000 s in each circuit throughout assessment. No clot initiation was detected by thromboelastography. Thrombin generation was decreased in circuits anticoagulated with argatroban versus heparin, despite aPTTs being less prolonged. These results suggest that argatroban may be more efficacious than heparin for anticoagulation in ECMO. Additional studies are warranted to further evaluate argatroban in this setting. |
| Databáze: | OpenAIRE |
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