Monitoring of Argatroban in Critically Ill Patients: A Prospective Study Comparing Activated Partial Thromboplastin Time, Point-of-Care Viscoelastic Testing with Ecarin Clotting Time and Diluted Thrombin Time to Mass Spectrometry

ConclusionsAlthough activated PTT monitoring of argatroban is the most commonly used test, in critically ill patients, diluted TT provides more precise measurements. Alternately, point-of-care viscoelastic ecarin clotting time also provides guidance for argatroban dosing to identify overdosing if available. The data also suggested that patients with sepsis are at greater risk for argatroban overdosing.Editor ’s PerspectiveWhat We Already Know about This TopicIntravenous direct thrombin inhibitors, bivalirudin and argatroban, are indicated for treating heparin-induced thrombocytopenia and used off-label with heparin resistance, extracorporeal membrane oxygenation, and hypercoagulabilityUnlike heparin, direct drug monitoring is not routinely available, and dosing is based on activated partial thromboplastin time or diluted thrombin timeWhat This Article Tells Us That Is NewAlthough activated partial thromboplastin time monitoring of argatroban is the most commonly used test, diluted thrombin time and point-of-care viscoelastic ecarin clotting times provide improved guidance for optimal dosing and identifying overdosing
Source: Anesthesiology - Category: Anesthesiology Source Type: research