Heparin vs bivalirudin anticoagulation for extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) induces hemostatic alterations that may contribute to hematological complications. Unfractionated heparin (UFH) is the mainstay antithrombotic in ECMO and depends on antithrombin III (AT III) to exhibit its actions. However, it bears the risk for heparin‐induced thrombocytopenia. Bivalirudin is a direct thrombin inhibitor and is inherently not dependent on AT III.

[1]  S. Stanworth,et al.  Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service , 2018, Transfusion.

[2]  M. Lillyblad,et al.  Evaluation of Systemic Heparin Versus Bivalirudin in Adult Patients Supported by Extracorporeal Membrane Oxygenation , 2017, ASAIO journal.

[3]  J. Fraser,et al.  Bivalirudin for Alternative Anticoagulation in Extracorporeal Membrane Oxygenation: A Systematic Review , 2017, Journal of intensive care medicine.

[4]  M. Buck.  Bivalirudin as an Alternative to Heparin for Anticoagulation in Infants and Children. , 2015, The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG.

[5]  A. Zangrillo,et al.  Bivalirudin versus heparin as an anticoagulant during extracorporeal membrane oxygenation: a case-control study. , 2013, Journal of cardiothoracic and vascular anesthesia.

[6]  M. Ranucci,et al.  Bivalirudin-based versus conventional heparin anticoagulation for postcardiotomy extracorporeal membrane oxygenation , 2011, Critical care.

[7]  R. Powell,et al.  Heparin induced thrombocytopenia: diagnosis and management update , 2007, Postgraduate Medical Journal.

[8]  John A Kellum,et al.  Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury , 2007, Critical care.

[9]  T. Kiser,et al.  Evaluation of Bivalirudin Treatment for Heparin‐Induced Thrombocytopenia in Critically Ill Patients with Hepatic and/or Renal Dysfunction , 2006, Pharmacotherapy.

[10]  K. Stringer,et al.  Bivalirudin: A Direct Thrombin Inhibitor for Percutaneous Transluminal Coronary Angioplasty , 2002, Pharmacotherapy.

[11]  M. Lancé,et al.  ECMO and anticoagulation : a comprehensive review , 2018 .

[12]  L. Hyland.  ANTICOAGULANT THERAPY. , 1964, Minnesota medicine.