초록접수 현황
| 15F-132 | 구연 발표 |
Use of Argatroban in ECLS Patients with Severe Thrombocytopenia: Analysis of 10 Consecutive Patients
조양현, 허정원, 양지혁, 성기익, 정치량, 양정훈, 서지영
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
Background : Argatroban is a direct thrombin inhibitor. It is widely used in patients who have confirmed or suspected diagnosis of heparin induced thrombocytopenia. Although extracorporeal life support (ECLS) requires systemic anticoagulation, there are only a few studies on use of argatroban in ECLS.
Methods : We identified patients who received argatroban infusion during ECLS between January 2014 and August 2015. Among 2** ECLS patients, 10 patients received argatroban as a systemic anticoagulant. Argatroban-responder was defined as platelet count > 100 (103/mm2) at 7 days after. We reviewed medical records of the patients.
Results : There were five male (50%). The median age was 54 years. Four patients (40%) had history of malignancy. Five patients were on dialysis. The modes of support were veno-venous in 5 (50%), Veno-arterial in 4 (40%), and veno-arterio-venous in 1 (10%). Median argatroban dose was 0.11mcg/Kg/min. There was no complications related to the argatroban. No patient was positive for platelet factor IV antibody. Platelet count in seven days after argatroban was significantly higher than that of before argatroban (p = 0.02, Figure 1). There were four argatroban-responder (40%). Predictors for argatroban-response were low plasma hemoglobin.
Conclusion : Argatroban use in ECLS patients with severe thrombocytopenia is a viable option. In some patients, argatroban use and quitting heparin can improve thrombocytopenia.
Methods : We identified patients who received argatroban infusion during ECLS between January 2014 and August 2015. Among 2** ECLS patients, 10 patients received argatroban as a systemic anticoagulant. Argatroban-responder was defined as platelet count > 100 (103/mm2) at 7 days after. We reviewed medical records of the patients.
Results : There were five male (50%). The median age was 54 years. Four patients (40%) had history of malignancy. Five patients were on dialysis. The modes of support were veno-venous in 5 (50%), Veno-arterial in 4 (40%), and veno-arterio-venous in 1 (10%). Median argatroban dose was 0.11mcg/Kg/min. There was no complications related to the argatroban. No patient was positive for platelet factor IV antibody. Platelet count in seven days after argatroban was significantly higher than that of before argatroban (p = 0.02, Figure 1). There were four argatroban-responder (40%). Predictors for argatroban-response were low plasma hemoglobin.
Conclusion : Argatroban use in ECLS patients with severe thrombocytopenia is a viable option. In some patients, argatroban use and quitting heparin can improve thrombocytopenia.
책임저자: 조양현
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
연락처 : 조양현, Tel: 02-3410-3313 , E-mail : mdcho95@gmail.com
