PMID- 37934717
OWN - NLM
STAT- MEDLINE
DCOM- 20240228
LR  - 20240228
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 70
IP  - 3
DP  - 2024 Mar 1
TI  - Argatroban Use in Pediatric Patients Supported by Paracorporeal Ventricular 
      Assist Devices.
PG  - 224-229
LID - 10.1097/MAT.0000000000002086 [doi]
AB  - Direct thrombin inhibitor (DTI) use has been associated with decreased stroke and 
      death rates in children on ventricular assist devices (VADs). Most information 
      about DTI use for children on VADs has focused on bivalirudin with limited data 
      on argatroban. We hypothesized that, compared to unfractionated heparin (UFH), 
      argatroban would be associated with decreased bleeding, stroke, and death rates 
      in children on VADs. We retrospectively collected data from patients <18 years 
      old on paracorporeal VADs at Children's Wisconsin between January 1, 2010 and 
      July 1, 2021. We divided patients into cohorts based on anticoagulation strategy 
      with heparin or argatroban. Definitions of bleeding and neurologic events were 
      the same as in other published reports on this population. We compared 
      categorical variables with the chi 2 or Fisher's exact test, and continuous 
      variables with the Mann-Whitney U test. Nineteen children were anticoagulated 
      with argatroban, and 16 with heparin. Demographics between groups were not 
      significantly different. Stroke, bleeding, and death rates did not differ between 
      patients treated with UFH versus argatroban. The study population was complex 
      with a high rate of extracorporeal membrane oxygenation (ECMO) use before VAD 
      support, which likely impacted our findings. Our study does not support 
      argatroban as a superior alternative anticoagulant compared to UFH in children 
      requiring VADs.
CI  - Copyright (c) ASAIO 2023.
FAU - Tuttle, Merritt G
AU  - Tuttle MG
AUID- ORCID: 0000-0003-3557-8120
AD  - From the Department of Pediatric Critical Care Medicine, Medical College of 
      Wisconsin, Milwaukee, Wisconsin.
FAU - Yan, Ke
AU  - Yan K
AD  - Department of Quantitative Health Sciences, Pediatrics, Medical College of 
      Wisconsin, Milwaukee, Wisconsin.
FAU - Zhang, Jian
AU  - Zhang J
AD  - Department of Quantitative Health Sciences, Pediatrics, Medical College of 
      Wisconsin, Milwaukee, Wisconsin.
FAU - Niebler, Robert A
AU  - Niebler RA
AD  - From the Department of Pediatric Critical Care Medicine, Medical College of 
      Wisconsin, Milwaukee, Wisconsin.
LA  - eng
PT  - Journal Article
DEP - 20231107
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 9005-49-6 (Heparin)
RN  - IY90U61Z3S (argatroban)
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 94ZLA3W45F (Arginine)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Sulfonamides)
SB  - IM
MH  - Humans
MH  - Child
MH  - Adolescent
MH  - Heparin/adverse effects
MH  - *Heart-Assist Devices
MH  - Retrospective Studies
MH  - Anticoagulants/therapeutic use
MH  - Antithrombins/therapeutic use
MH  - Hemorrhage/chemically induced
MH  - *Stroke
MH  - Arginine/*analogs & derivatives
MH  - *Pipecolic Acids
MH  - *Sulfonamides
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2023/11/07 18:42
MHDA- 2024/02/28 06:45
CRDT- 2023/11/07 13:13
PHST- 2024/02/28 06:45 [medline]
PHST- 2023/11/07 18:42 [pubmed]
PHST- 2023/11/07 13:13 [entrez]
AID - 00002480-990000000-00347 [pii]
AID - 10.1097/MAT.0000000000002086 [doi]
PST - ppublish
SO  - ASAIO J. 2024 Mar 1;70(3):224-229. doi: 10.1097/MAT.0000000000002086. Epub 2023 
      Nov 7.