天堂网亚洲,天天操天天搞,91视频高清,菠萝蜜视频在线观看入口,美女视频性感美女视频,95丝袜美女视频国产,超高清美女视频图片

ChemicalBook >> journal list >> Pediatric Critical Care Medicine >>article
Pediatric Critical Care Medicine

Pediatric Critical Care Medicine

IF: 4
Download PDF

Evaluation of Bivalirudin As an Alternative to Heparin for Systemic Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation.

Published:1 September 2020 DOI: 10.1097/PCC.0000000000002384 PMID: 32404633
Mohammed Hamzah, Angela M Jarden, Chidiebere Ezetendu, Robert Stewart

Abstract

Objectives: Heparin is the universal anticoagulant for patients receiving extracorporeal membrane oxygenation support. However, heparin has many disadvantages, especially in young children, who develop heparin resistance. Recently our center has used bivalirudin, a direct thrombin inhibitor, for systemic anticoagulation in pediatric extracorporeal life support. Bivalirudin binds directly to thrombin with no need for antithrombin III and it inhibits both circulating and clot-bound thrombin. In this study, we sought to evaluate our experience with bivalirudin in pediatric extracorporeal life support.

Design: Retrospective chart review study of patients receiving extracorporeal membrane oxygenation support between October 2014 and May 2018.

Setting: Tertiary, academic PICU.

Patients: Sixteen patients receiving heparin and 16 patients receiving bivalirudin on extracorporeal life support were included in the study.

Interventions: None.

Measurements and main results: Patients in the bivalirudin group had a median age of 31 months versus 59 months in the heparin group (p = 0.41). Recovery and extracorporeal membrane oxygenation decannulation were similar in both groups (56% in the heparin group and 62% in the bivalirudin group; p = 0.62). Time to reach goal therapeutic anticoagulation level was shorter in the bivalirudin group (11 vs 29?hr; p = 0.01). Bleeding events were fewer in the bivalirudin group, and there was no difference in the rate of thrombotic events between the two groups. Comprehensive cost analysis that includes anticoagulant, laboratories, and antithrombin III cost, showed that heparin anticoagulation therapy total cost was significantly higher than bivalirudin (1,184 dollars per day in heparin group vs 494 dollars per day in bivalirudin group; p = 0.03). Bivalirudin dose required to maintain target anticoagulation will increase over time, and this is associated with an increase in creatinine clearance and an increase in fibrinogen serum levels.

Conclusions: This study showed that the use of bivalirudin in pediatric extracorporeal membrane oxygenation support is feasible, safe, reliable, and cost-effective in comparison to heparin. Further prospective randomized clinical trials are necessary to confirm our observations.

Substances (6)

Related products
Procduct Name CAS Molecular Formula Supplier Price
Creatinine 60-27-5 C4H7N3O 633 suppliers $5.00-$4187.46
Bivalirudin 128270-60-0 C98H138N24O33 428 suppliers $55.00-$2425.50
Thrombin 9002-04-4 NULL 196 suppliers $73.90-$58500.00
HUMAN FIBRINOGEN 9001-32-5 C6H14O6 183 suppliers $29.00-$7020.00
Heparin 9005-49-6 C26H41NO34S4 122 suppliers Inquiry
ANTITHROMBIN III 90170-80-2 NULL 34 suppliers $266.00-$838.00

Similar articles

IF:2.2

Bivalirudin in pediatric extracorporeal membrane oxygenation

Current opinion in pediatrics L. Ryerson,?A. McMichael,etc Published: 1 June 2022
IF:6.2

Assessment of ethylene glycol diacetate as an alternative carrier for use in agrochemical emulsifiable concentrate formulation

Ecotoxicology and Environmental Safety Xian-peng Zhang , Tong-fang Jing ,etc Published: 15 November 2018
IF:3.7

Daidzein from Dietary Supplement to a Drug Candidate: An Evaluation of Potential

ACS Omega Mohammed Ubaid,  Salauddin,etc Published: 27 August 2023