• Timothy Cornell, Polly Wyrick, Geoffrey Fleming, Deborah Pasko, Yong Han, Joseph Custer, Jonathan Haft, and Gail Annich.
• Critical Care Medicine, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan 48109, USA.
• ASAIO J. 2007 Jul 1;53(4):460-3.

AbstractAnticoagulation for extracorporeal life support (ECLS) is routinely achieved using heparin, which can be difficult in patients suspected of having heparin-induced thrombocytopenia. We describe a case series of five patients in which we used argatroban, a direct thrombin inhibitor, as an alternative to heparin for systemic anticoagulation during ECLS in patients suspected to have heparin-induced thrombocytopenia. Argatroban was used to achieve target systemic anticoagulation for activate clotting times between 210 and 230. Duration of argatroban use while on ECLS ranged from 6 to 184 hours. Argatroban dosage ranged from 0.2 to 3.5 microg/kg/min. Activated clotting times showed good agreement with aPTT. In conclusion, we illustrate that argatroban is a reasonable alternative to heparin anticoagulation for patients requiring ECLS.

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