Case Report

Argatroban in Adult Extracorporeal Membrane Oxygenation

Department of Cardiothoracic Surgery. The University of Texas Southwestern Medical Center at Dallas

^* Address correspondence to: Nicklett Johnston, RN BSN, CCP, Department of Cardiothoracic Surgery, University of Texas Southwestern Medical Center at Dallas, 5161 Harry Hines Boulevard, Dallas, TX 75390-8879. E-mail: johnstonr@sbcglobal.net

Received: January 2002
Accepted: August 2002

Abstract

This case report addresses the use of Argatroban, an anticoagulant and thrombin inhibitor for treatment of thrombocytopenia in an adult patient on extracorporeal membrane oxygenation (ECMO). After 5 days on ECMO, the patient showed signs of heparin-induced thrombocytopenia (HIT) with a platelet count of 20K. Argatroban was initiated to decrease progression of HIT and continue treatment with ECMO proved to be successful. Given the occurrence of HIT with heparin therapy, a need for alternate drug therapy is required for patients requiring treatment with ECMO. The use of Argatroban in adult ECMO is outlined and includes dosage, monitoring, and patient treatment.