Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass.

Journal of Anaesthesiology, Clinical Pharmacology
Shvetank AgarwalMichael Okumura

Abstract

Use of argatroban as an alternative to heparin during cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia has gained some attention in the past two decades. Dosing of argatroban during CPB is complex due to lack of complete understanding of its pharmacokinetic profile and the various elements during CPB that may alter its plasma levels. We report a case where the challenges in dosing argatroban led to failure to provide adequate anticoagulation during CPB, as evidenced by clot formation in the oxygenator, and extensive bleeding in the postoperative period.

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Citations

Sep 14, 2012·Expert Opinion on Drug Metabolism & Toxicology·Ignacio Cruz-GonzálezBryan P Yan
Nov 18, 2015·Therapeutic Hypothermia and Temperature Management·Amanda R StahlKelly N Sawyer
Feb 24, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Aurore BouraghdaPierre Albaladejo
Oct 30, 2016·Thrombosis and Haemostasis·Sixten Selleng, Kathleen Selleng
Jan 2, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Gregory J LathamDavid Michael McMullan
Feb 14, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Kent H Rehfeldt, David W Barbara
Aug 25, 2020·Anesthesia and Analgesia·Sergiy M NadtochiyMichael P Eaton
Feb 11, 2021·Journal of Clinical Medicine·Enrico SquiccimarroRoberto Lorusso
Dec 7, 2018·Journal of Cardiothoracic and Vascular Anesthesia·Natalia S IvascuJacob Gutsche

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Methods Mentioned

BETA
coronary artery bypass

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