Activated partial thromboplastin time and anti-Ila monitoring in argatroban anticoagulation in COVID-19 patients on venovenous extracorporeal membrane oxygenation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F25%3AE0111701" target="_blank" >RIV/00843989:_____/25:E0111701 - isvavai.cz</a>

Result on the web

<a href="https://journals.sagepub.com/doi/10.1177/10760296251341315" target="_blank" >https://journals.sagepub.com/doi/10.1177/10760296251341315</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1177/10760296251341315" target="_blank" >10.1177/10760296251341315</a>

Result language

angličtina

Original language name

Activated partial thromboplastin time and anti-Ila monitoring in argatroban anticoagulation in COVID-19 patients on venovenous extracorporeal membrane oxygenation

Original language description

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.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Clinical and applied thrombosis/hemostasis

ISSN

1076-0296

e-ISSN

1938-2723

Volume of the periodical

31

Issue of the periodical within the volume

article 10760296251341315

Country of publishing house

US - UNITED STATES

Number of pages

10

Pages from-to

1-10

UT code for WoS article

001492873100001

EID of the result in the Scopus database

2-s2.0-105005846028