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10.1053/j.jvca.2020.06.059 http://scihub22266oqcxt.onion/10.1053/j.jvca.2020.06.059 32660924!7315936!32660924     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=32660924&cmd=llinks): Failed to open stream: HTTP request failed! 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Bivalirudin for Maintenance Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation for COVID-19 |pdf=|usr=}}{{32660924}} gab.com Text Bivalirudin for Maintenance Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation for COVID-19 JO: J Cardiothorac Vasc Anesth http://www.kidney.de/pget.php?&tw=1&pmid=32660924 #FOAvip In its severe manifestation, coronavirus disease 2019 (COVID-19) compromises oxygenation in a manner that is refractory to maximal conventional support and requires escalation to extracorporeal membrane oxygenation (ECMO). Maintaining ECMO support for extended durations requires a delicately balanced anticoagulation strategy to maintain circuit viability by preventing thrombus deposition while avoiding excessive anticoagulation yielding hemorrhage-a task that is complicated in COVID-19 secondary to an inherent hypercoagulable state. Bivalirudin, a member of the direct thrombin inhibitor drug class, offers potential advantages during ECMO, including to its ability to exert its effect by directly attaching to and inhibiting freely circulating and fibrin-bound thrombin. Herein, the successful use of an anticoagulation strategy using the off-label use of a continuous infusion of bivalirudin in a case of severe hypoxemic and hypercarbic respiratory failure caused by COVID-19 requiring venovenous ECMO is reported. Importantly, therapeutic anticoagulation intensity was achieved rapidly with stable pharmacokinetics, and there was no need for any circuit interventions throughout the patient's 27-day ECMO course. In COVID-19, bivalirudin offers a potential option for maintaining systemic anticoagulation during ECMO in a manner that may mitigate the prothrombotic nature of the underlying pathophysiologic state. Twit Text FOAVip Bivalirudin for Maintenance Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation for COVID-19 ????J Cardiothorac Vasc Anesth http://www.kidney.de/pget.php?&tw=1&pmid=32660924 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32660924 #FOAvip English Wikipedia <ref>{{Cite pmid|32660924}}</ref> Bivalirudin for Maintenance Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation for COVID-19 #MMPMID32660924 Seelhammer TG; Rowse P; Yalamuri S J Cardiothorac Vasc Anesth 2021[Apr]; 35 (4): 1149-1153 PMID32660924show ga In its severe manifestation, coronavirus disease 2019 (COVID-19) compromises oxygenation in a manner that is refractory to maximal conventional support and requires escalation to extracorporeal membrane oxygenation (ECMO). Maintaining ECMO support for extended durations requires a delicately balanced anticoagulation strategy to maintain circuit viability by preventing thrombus deposition while avoiding excessive anticoagulation yielding hemorrhage-a task that is complicated in COVID-19 secondary to an inherent hypercoagulable state. Bivalirudin, a member of the direct thrombin inhibitor drug class, offers potential advantages during ECMO, including to its ability to exert its effect by directly attaching to and inhibiting freely circulating and fibrin-bound thrombin. Herein, the successful use of an anticoagulation strategy using the off-label use of a continuous infusion of bivalirudin in a case of severe hypoxemic and hypercarbic respiratory failure caused by COVID-19 requiring venovenous ECMO is reported. Importantly, therapeutic anticoagulation intensity was achieved rapidly with stable pharmacokinetics, and there was no need for any circuit interventions throughout the patient's 27-day ECMO course. In COVID-19, bivalirudin offers a potential option for maintaining systemic anticoagulation during ECMO in a manner that may mitigate the prothrombotic nature of the underlying pathophysiologic state. |Aged[MESH] |Anticoagulants/*administration & dosage/therapeutic use[MESH] |Antithrombins/*administration & dosage/therapeutic use[MESH] |COVID-19 Nucleic Acid Testing[MESH] |COVID-19/complications/*diagnosis/*therapy[MESH] |Extracorporeal Membrane Oxygenation/*adverse effects[MESH] |Female[MESH] |Hirudins/*administration & dosage[MESH] |Humans[MESH] |Peptide Fragments/*administration & dosage/therapeutic use[MESH] |Polymerase Chain Reaction[MESH] |Recombinant Proteins/administration & dosage/therapeutic use[MESH] |Respiratory Insufficiency/etiology/therapy[MESH] |SARS-CoV-2/genetics/isolation & purification[MESH] |Thrombosis/*prevention & control[MESH]Bivalirudin for Maintenance Anticoagulation During Venovenous Extracor(epmc).pdf DeepDyve Pubget Overpricing