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CASE REPORT
Year : 2012  |  Volume : 28  |  Issue : 1  |  Page : 106-110

Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass


Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI, USA

Correspondence Address:
Shvetank Agarwal
Department of Anesthesiology, Wayne State University/Detroit Medical Center, 3990 John R., Box 162, Detroit, MI 48201
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.92458

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Use of argatroban as an alternative to heparin during cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia has gained some attention in the past two decades. Dosing of argatroban during CPB is complex due to lack of complete understanding of its pharmacokinetic profile and the various elements during CPB that may alter its plasma levels. We report a case where the challenges in dosing argatroban led to failure to provide adequate anticoagulation during CPB, as evidenced by clot formation in the oxygenator, and extensive bleeding in the postoperative period.


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