Open AccessChallenges encountered with argatroban anticoagulation during cardiopulmonary bypass
Author(s) -
Shvetank Agarwal,
Beth Ullom,
Yasser Al-Baghdadi,
Michael Okumura
Publication year - 2012
Publication title -
journal of anaesthesiology-clinical pharmacology/journal of anaesthesiology clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.466
H-Index - 32
eISSN - 2231-2730
pISSN - 0970-9185
DOI - 10.4103/0970-9185.92458
Subject(s) - argatroban , medicine , cardiopulmonary bypass , oxygenator , dosing , heparin , heparin induced thrombocytopenia , anesthesia , intensive care medicine , surgery , pharmacology , platelet , thrombin
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.