Non-heparin-based Anticoagulation:
If it is necessary to use an agent other than heparin while on ECMO, the hematology service should be directly involved.
Bivlirudin
- Bivalirudin is a direct thrombin inhibitor.
- It can be used as a bolus and infusion similar to how heparin is used.
- It has a half life of about 25 minutes.
- Although ACT can be used to measure the effectiveness of bivalirudin, in practice it is harder to titrate.
- There is no antidote to bivalirudin.
Argatroban
- Argatroban is another direct thrombin inhibitor.
- It can be used as a bolus and infusion similar to how heparin is used.
- The ACT and aPTT are used to measure argatroban's effectiveness.
Next page: Anticoagulation and ECMO: ECMO without anticoagulation