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10.1177/10600280211036151

http://scihub22266oqcxt.onion/10.1177/10600280211036151
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34323121!ä!34323121

suck abstract from ncbi


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pmid34323121      Ann+Pharmacother 2022 ; 56 (4): 387-392
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  • Evaluation of Bivalirudin as the Primary Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation for SARS-CoV-2-Associated Acute Respiratory Failure #MMPMID34323121
  • Bissell BD; Gabbard T; Sheridan EA; Baz MA; Davis GA; Ather A
  • Ann Pharmacother 2022[Apr]; 56 (4): 387-392 PMID34323121show ga
  • 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.
  • |*COVID-19/complications/therapy[MESH]
  • |*Extracorporeal Membrane Oxygenation/adverse effects/methods[MESH]
  • |*Respiratory Insufficiency/therapy[MESH]
  • |Anticoagulants/adverse effects[MESH]
  • |Hirudins[MESH]
  • |Humans[MESH]
  • |Peptide Fragments[MESH]
  • |Recombinant Proteins[MESH]
  • |Retrospective Studies[MESH]


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