Clinical application of argatroban as an alternative anticoagulant for extracorporeal circulation

The authors attempted experimental and clinical use of argatroban as an alt ernative anticoagulant in left heart bypass with the centrifugal pump, perc utaneous cardiopulmonary support (PCPS), and extracorporeal membrane oxygen ation (ECMO) to determine if it has complementary effects in preventing thr ombus formation without aggravating bleeding tendency. its reversible bindi ng to thrombin and its short half-life contributed to reduce the risk of ex cessive blood loss without clot formation within the extracorporeal circula tion circuit during thoracic aortic surgery using left heart bypass. PCPS a nd ECMO were safely performed at doses ranging from 0.5 to 10 mu g/kg/min t o maintain activated clotting time at approximately 200 seconds. Although e xperimental studies showed argatroban to be advantageous in preserving plat elet and fibrinogen, further clinical investigations are necessary.