| Title |
Efficacy and safety of argatroban in patients with acute respiratory distress syndrome and extracorporeal lung support
|
|---|---|
| Published in |
Annals of Intensive Care, August 2017
|
| DOI | 10.1186/s13613-017-0302-5 |
| Pubmed ID | |
| Authors |
Mario Menk, Philipp Briem, Björn Weiss, Martina Gassner, David Schwaiberger, Anton Goldmann, Christian Pille, Steffen Weber-Carstens |
| Abstract |
Extracorporeal membrane oxygenation (ECMO) or pumpless extracorporeal lung assist (pECLA) requires effective anticoagulation. Knowledge on the use of argatroban in patients with acute respiratory distress syndrome (ARDS) undergoing ECMO or pECLA is limited. Therefore, this study assessed the feasibility, efficacy and safety of argatroban in critically ill ARDS patients undergoing extracorporeal lung support. This retrospective analysis included ARDS patients on extracorporeal lung support who received argatroban between 2007 and 2014 in a single ARDS referral center. As controls, patients who received heparin were matched for age, sex, body mass index and severity of illness scores. Major and minor bleeding complications, thromboembolic events, administered number of erythrocyte concentrates, thrombocytes and fresh-frozen plasmas were assessed. The number of extracorporeal circuit systems and extracorporeal lung support cannulas needed due to clotting was recorded. Also assessed was the efficacy to reach the targeted activated partial thromboplastin time (aPTT) in the first consecutive 14 days of therapy, and the controllability of aPTT values is within a therapeutic range of 50-75 s. Fisher's exact test, Mann-Whitney U tests, Friedman tests and multivariate nonparametric analyses for longitudinal data (MANOVA; Brunner's analysis) were applied where appropriate. Of the 535 patients who met the inclusion criteria, 39 receiving argatroban and 39 matched patients receiving heparin (controls) were included. Baseline characteristics were similar between the two groups, including severity of illness and organ failure scores. There were no significant differences in major and minor bleeding complications. Rates of thromboembolic events were generally low and were similar between the two groups, as were the rates of transfusions required and device-associated complications. The controllability of both argatroban and heparin improved over time, with a significantly increasing probability to reach the targeted aPTT corridor over the first days (p < 0.001). Over time, there were significantly fewer aPTT values below the targeted aPTT goal in the argatroban group than in the heparin group (p < 0.05). Both argatroban and heparin reached therapeutic aPTT values for adequate application of extracorporeal lung support. Argatroban appears to be a feasible, effective and safe anticoagulant for critically ill ARDS patients undergoing extracorporeal lung support. |
X Demographics
The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Germany | 1 | 25% |
| Japan | 1 | 25% |
| Unknown | 2 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 25% |
| Practitioners (doctors, other healthcare professionals) | 1 | 25% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 7 | 15% |
| Other | 6 | 13% |
| Student > Ph. D. Student | 6 | 13% |
| Researcher | 5 | 10% |
| Student > Master | 4 | 8% |
| Other | 7 | 15% |
| Unknown | 13 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 60% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 4% |
| Psychology | 1 | 2% |
| Engineering | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 12 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 May 2021.
All research outputs
#12,856,775
of 22,996,001 outputs
Outputs from Annals of Intensive Care
#667
of 1,052 outputs
Outputs of similar age
#146,373
of 317,594 outputs
Outputs of similar age from Annals of Intensive Care
#16
of 22 outputs
Altmetric has tracked 22,996,001 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
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We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.