The use of argatroban as an anti-coagulant for percutaneous cardiopulmonary support in a patient with suspected heparin-induced thrombocytopenia (HIT)

Abstract

We administered argatroban as an anticoagulant for percutaneous cardiopulmonary support (PCPS) in a patient suspected to have heparin-induced thrombocytopemia (HIT). Before the HIT antibody turned out to be negative, we stopped the administration of heparin, and instead begin to administer another anticoagulant for patients strongly suspected HIT. The efficacy of argatorban for HIT has been previously reported, however, the efficacy of the use of argatroban through an extracorporeal device remains to be elucidated. In this case, we performed PCPS for 15 days under the administration of argatorban while adjusting the dose to maintain activated clotting time (ACT) in the same range as that achieved when administering heparin and no complications such as thrombosis or bleeding occurred. This case demonstrated that argatroban was effective as an anticoagulant for PCPS. It is necessary to further discuss the optimal dosage of ACT, however, argatroban was found to be effective as an anticoagulant for PCPS in a patient with HIT.