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Activated Partial Thromboplastin Time and Anti-IIa Monitoring in Argatroban Anticoagulation in COVID-19 Patients on Venovenous Extracorporeal Membrane Oxygenation
F. Burša, M. Frelich, P. Sklienka, S. Němcová, Z. Kučerová, O. Jor, T. Romanová, A. Kondé, J. Janošek, J. Sagan, J. Máca
Jazyk angličtina
Typ dokumentu časopisecké články, pozorovací studie
NLK
Directory of Open Access Journals
od 2019
PubMed Central
od 2018
Europe PubMed Central
od 2018
ProQuest Central
od 1995-01-01
Medline Complete (EBSCOhost)
od 1995-01-01
Health & Medicine (ProQuest)
od 1995-01-01
ROAD: Directory of Open Access Scholarly Resources
od 1995
- MeSH
- antikoagulancia * terapeutické užití škodlivé účinky aplikace a dávkování MeSH
- arginin analogy a deriváty MeSH
- COVID-19 * krev terapie mortalita komplikace MeSH
- dospělí MeSH
- farmakoterapie COVID-19 * MeSH
- krvácení chemicky indukované MeSH
- kyseliny pipekolové * terapeutické užití aplikace a dávkování škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody MeSH
- monitorování léčiv metody MeSH
- parciální tromboplastinový čas MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- sulfonamidy MeSH
- trombóza prevence a kontrola etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Unfractionated heparin has long been considered the standard anticoagulation in ECMO, despite some pitfalls such as heparin resistance, heparin induced thrombocytopenia (HIT), etc Recently, some centres started to increasingly use argatroban for this purpose, typically using activated partial thromboplastin time (aPTT) for its monitoring. Direct monitoring of the efficacy of argatroban using Anti-IIa is not yet an established method, although it might be more appropriate as it targets the same pathway.An observational study was performed in adult veno-venous ECMO patients hospitalized with SARS-CoV-2 infection anticoagulated with argatroban to an aPTT target of 40-60 s and Anti-IIa target of 0.4-0.6 μg/mL. Bleeding and thrombotic complications were monitored.Forty-four VV ECMO patients were included, with an overall hospital mortality of approx. 50%. No life-threatening thrombotic events were recorded. The risk of bleeding complications significantly increased with aPTT above 52.7 s and with Anti-IIa values over 0.78 μg/mL. Using the above cut-offs for both the aPTT and Anti-IIa and their combination, the negative predictive value for bleeding was approximately 90%.It seems that the generally recommended limits for Anti-IIa of 1.5 μg/mL may be high. However, further data are needed to confirm lower limits.Trial Registration:retrospectively registered in ClinicalTrials.gov, NCT06038682.
Citace poskytuje Crossref.org
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