Therapeutic Anticoagulation With an Ultra-Low Concentration Argatroban-Based Purge Solution for Percutaneous Ventricular Assist Device in Patient With Heparin-Induced Thrombocytopenia. (August 2021)

• Record Type: Journal Article
• Authors: Newsome, Andrea Sikora; Taylor, Ashley; Garner, Seth
• Is Part Of: Hospital pharmacy. Volume 56:Number 4(2021)
• Page Start: 241
• Page End: 246
• Publication Date: 2021-08
• Subjects: gram-negative bacteria -- pseudomonas aeruginosa -- microbiology -- anti-bacterial agents -- intensive care units; Hospital pharmacies -- Periodicals; Pharmacy Service, Hospital; Hospital pharmacies; Periodicals; Periodicals; 615.1
• DOI: 10.1177/0018578719888905
• Languages: English
• ISSNs: 0018-5787

Abstract

Purpose/Background: Percutaneous left ventricular assist devices (pVADs) require a continuous purge solution containing heparin to prevent pump thrombosis and device failure. Data regarding alternative options in patients who have suspected heparin-induced thrombocytopenia (HIT) are limited.Methods: In this report, we describe a 68-year-old white man with cardiogenic shock with an Impella CP device managed with a low concentration argatroban-based purge solution secondary to a suspected diagnosis of HIT.Results: The purge solution was initiated as argatroban in dextrose 10% at a concentration of 0.12 mg/mL and was subsequently decreased twice to 0.06 and 0.015 mg/mL based on the patient's clinical course.Conclusions: This case report describes the safe and effective use of argatroban purge solution necessary for anticoagulation although further studies are needed to confirm these findings.