Argatroban in adult extracorporeal membrane oxygenation.
This case report addresses the use of Argatroban, an anticoagulant and thrombin inhibitor for treatment of thrombocytopenia in an adult patient on extracorporeal membrane oxygenation (ECMO). After 5 days on ECMO, the patient showed signs of heparin-induced thrombocytopenia (HIT) with a platelet count of 20K. Argatroban was initiated to decrease progression of HIT and continue treatment with ECMO proved to be successful. Given the occurrence of HIT with heparin therapy, a need for alternate drug therapy is required for patients requiring treatment with ECMO. The use of Argatroban in adult ECMO is outlined and includes dosage, monitoring, and patient treatment.
Johnston
Nicklett
N
Department of Cardiothoracic Surgery, The University of Texas Southwestern Medical Center at Dallas, 75390-8879, USA. johnstonr@sbcglobal.net
Wait
Michael
M
Huber
Lynne
L
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D000991:Antithrombins / Q000008:administration & dosage* / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D010875:Pipecolic Acids / Q000008:administration & dosage* / Q000627:therapeutic use; D013449:Sulfonamides; D013781:Texas; D013921:Thrombocytopenia / Q000139:chemically induced / Q000517:prevention & control*
D000925:Anticoagulants; D000991:Antithrombins; D020099:Coated Materials, Biocompatible; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban