Article ; Online: Evaluation of Bivalirudin as the Primary Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation for SARS-CoV-2-Associated Acute Respiratory Failure.
2021 Volume 56, Issue 4, Page(s) 387–392
Abstract: ... All patients with acute respiratory failure requiring ECMO with a positive SARS-CoV-2 polymerase chain reaction ... center retrospective chart review over a 9-month period of patients receiving bivalirudin while on ECMO ... for anticoagulation in the setting of ECMO for COVID-19-associated respiratory failure.: Methods: This was a single ...
| Abstract | Background: Extracorporeal membrane oxygenation (ECMO) is a potential option for the management of severe acute respiratory failure secondary to COVID-19. Conflicting the use of this therapy is the known coagulopathy within COVID-19, leading to an incidence of venous thrombotic events of 25% to 49%. To date, limited guidance is available on optimal anticoagulation strategies in this population. Objective: The purpose of this study was to evaluate the utilization of a pharmacist-driven bivalirudin dosing protocol for anticoagulation in the setting of ECMO for COVID-19-associated respiratory failure. Methods: This was a single-center retrospective chart review over a 9-month period of patients receiving bivalirudin while on ECMO. All patients with acute respiratory failure requiring ECMO with a positive SARS-CoV-2 polymerase chain reaction were included. Bivalirudin was dosed via aPTT monitoring after a starting dose of 0.2 or 0.3 mg/kg/h. Results: There were 33 patients included in this study, all receiving mechanical ventilation. The most common starting dose of bivalirudin was 0.2 mg/kg/h, with an average time to therapeutic range of 20 hours. Compared to previous reports, rates of bleeding were low at 15.1%, and 6.1% of patients developed a new venous thromboembolic event while on ECMO. ECMO survival was 51.5%, with an ICU mortality rate of 48.5%. Conclusion and relevance: In the first published report of its use within this population, bivalirudin was found to be a viable choice for anticoagulation in those patients on ECMO for severe respiratory failure secondary to COVID-19. |
|||||
|---|---|---|---|---|---|---|
| MeSH term(s) | Anticoagulants/adverse effects ; COVID-19/complications ; COVID-19/therapy ; Extracorporeal Membrane Oxygenation/adverse effects ; Extracorporeal Membrane Oxygenation/methods ; Hirudins ; Humans ; Peptide Fragments ; Recombinant Proteins ; Respiratory Insufficiency/therapy ; Retrospective Studies ; SARS-CoV-2 | |||||
| Chemical Substances | Anticoagulants ; Hirudins ; Peptide Fragments ; Recombinant Proteins ; bivalirudin (TN9BEX005G) | |||||
| Language | English | |||||
| Publishing date | 2021-07-29 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 1101370-9 | |||||
| ISSN | 1542-6270 ; 1060-0280 | |||||
| ISSN (online) | 1542-6270 | |||||
| ISSN | 1060-0280 | |||||
| DOI | 10.1177/10600280211036151 | |||||
| Shelf mark |
|
|||||
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.A 900: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.