A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support
AbstractAs the use of mechanical circulatory support has increased in volume and complexity, anticoagulation remains an intricate component of a patient ’s pharmacotherapy plan. Traditionally, heparin has been the primary anticoagulant utilized because of its ease of titration and familiarity of use. More recently, bivalirudin, a direct thrombin inhibitor, has attracted attention as a potential alternative to traditional therapy. While labeled f or use in percutaneous coronary interventions, it is utilized off-label for heparin-induced thrombocytopenia and mechanical circulatory support. A literature search identified ten studies in which bivalirudin was used in extracorporeal membrane oxygenation and five studies in which it was used in ve ntricular assist devices. The purpose of this review was to summarize the currently available literature for bivalirudin use for mechanical circulatory support in both adult and pediatric patients.
This study assessed the effectiveness and safety of proton pump inhibitors (PPIs) compared to histamine type 2 receptor antagonists (H2RAs) for prevention of CIGB in mechanically ventilated patients.DesignThis is a retrospective, single-center, pharmacoepidemiologic study.SettingThis study was carried out in six intensive care units (ICUs).PatientsCritically ill adults admitted between 9/1/14 and 9/1/19 who received PPIs or H2RAs within 24 h of intubation and for ≥48 h were included in this study.InterventionPPIs or H2RAs for stress ulcer prophylaxis.Measurements and Main ResultsPrimary outcomes were CIGB occ...
ConclusionThis study indicates that SIRT1 rs12778366 and rs4746720 may be genetic factors related to corticosteroid sensitivity in ITP patients.
ConclusionsAs far we are aware, this is the first time that we reported a comprehensive exploration of laboratory characteristics of a large cohort of hospitalized COVID-19 patients from Iran, hoping that these data will cast more light on the diagnostic significance of these parameters.
Arch Toxicol. 2021 Sep 14. doi: 10.1007/s00204-021-03154-5. Online ahead of print.ABSTRACTVenomous snakebites cause clinical manifestations that range from local to systemic and are considered a significant global health challenge. Persistent or refractory thrombocytopenia has been frequently reported in snakebite patients, especially in cases caused by viperidae snakes. Viper envenomation-induced thrombocytopenia may persist in the absence of significant consumption coagulopathy even after the antivenom treatment, yet the mechanism remains largely unknown. Our study aims to investigate the mechanism and discover novel the...
Int J Lab Hematol. 2021 Sep 14. doi: 10.1111/ijlh.13705. Online ahead of print.ABSTRACTIn December 2019, several cases of pneumonia of unknown aetiology were reported in Wuhan, China. The causative Coronavirus was subsequently isolated and named the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) and the disease, Coronavirus disease-2019 (COVID-19).1 COVID-19 related coagulopathy is a poor prognostic feature and reflects an underlying pathological process termed immunothrombosis.2 This process differs from infection-related disseminated intravascular coagulation (DIC) as it manifests primarily with thrombosis ...
Conclusions: Platelet nadir #x3c;100 × 103/ µL and platelet decrease by #x3e;50% following CRRT initiation were both associated with lower rates of renal recovery. Further research is needed to evaluate mechanisms-linking platelet changes and renal nonrecovery in CRRT.Blood Purif
Conclusions: The combined therapy with DEB-TACE followed by cTACE may be a new effective therapeutic strategy for the intermediate stage of HCC patients.
ConclusionCritical illness in patients with a newly diagnosed hematologic malignancy is frequent, occurring early after diagnosis. Certain baseline characteristics can help identify those patients at the highest risk.
ConclusionShape-based features of the left liver lobe show potential as non-invasive biomarkers of liver fibrosis and portal hypertension in children with ARPKD.Graphic abstract
Updated Guidance on Management. Version 2.2 31 August 2021