Use of fondaparinux in patients with heparin-induced
thrombocytopenia on veno-venous extracorporeal membrane
oxygenation: A three-patient case series report

J 2023

Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report

RYCHLÍČKOVÁ, Jitka, Vladimír ŠRÁMEK a Pavel SUK

Základní údaje

Originální název

Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report

Autoři

RYCHLÍČKOVÁ, Jitka (203 Česká republika, garant, domácí), Vladimír ŠRÁMEK (203 Česká republika, domácí) a Pavel SUK (203 Česká republika, domácí)

Vydání

Frontiers in Medicine, Lausanne, FRONTIERS MEDIA SA, 2023, 2296-858X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30104 Pharmacology and pharmacy

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.900 v roce 2022

Kód RIV

RIV/00216224:14110/23:00130657

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3389/fmed.2023.1112770

UT WoS

000945810700001

Klíčová slova anglicky

fondaparinux; pharmacokinetics; heparin-induced thrombocytopenia; extracorporeal membrane oxygenation; pharmacoeconomics

Štítky

14110122, 14110516, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 27. 4. 2023 10:17, Mgr. Tereza Miškechová

Anotace

V originále

Heparin-induced thrombocytopenia is a life-threatening immune-mediated complication of unfractionated heparin therapy. Fondaparinux is a therapeutic alternative, but it has limited evidence for its use in patients on extracorporeal membrane oxygenation (ECMO). We present a series of three adult patients with COVID-19 on ECMO who were diagnosed with heparin-induced thrombocytopenia after 7-12 days of unfractionated heparin treatment and were switched to fondaparinux. Fondaparinux was initiated with an intravenous loading dose of 5 mg, followed by a dose of 2.5 mg subcutaneously every 8-12 h. Dosage was adjusted according to daily measured anti-Xa concentration with a target range of 0.4-0.7 mg/L. The total duration of treatment with fondaparinux and ECMO ranged from 13 to 26 days. One major bleeding episode unrelated to fondaparinux therapy was observed, and the transfusions requirement was also low in all patients. The ECMO circuit was changed once in each patient. This series provides a deep insight into the use of fondaparinux over an extended period of time in patients on ECMO. Based on the presented data, fondaparinux can be considered a reasonable and affordable anticoagulant in patients without a high risk of bleeding.

Citovat

RYCHLÍČKOVÁ, Jitka, Vladimír ŠRÁMEK a Pavel SUK. Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report. Frontiers in Medicine. Lausanne: FRONTIERS MEDIA SA, 2023, roč. 10, February 2023, s. 1-7. ISSN 2296-858X. Dostupné z: https://dx.doi.org/10.3389/fmed.2023.1112770.

@article{2278172,
   author = {Rychlíčková, Jitka and Šrámek, Vladimír and Suk, Pavel},
   article_location = {Lausanne},
   article_number = {February 2023},
   doi = {http://dx.doi.org/10.3389/fmed.2023.1112770},
   keywords = {fondaparinux; pharmacokinetics; heparin-induced thrombocytopenia; extracorporeal membrane oxygenation; pharmacoeconomics},
   language = {eng},
   issn = {2296-858X},
   journal = {Frontiers in Medicine},
   title = {Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report},
   url = {https://www.frontiersin.org/articles/10.3389/fmed.2023.1112770/full},
   volume = {10},
   year = {2023}
}

TY  - JOUR
ID  - 2278172
AU  - Rychlíčková, Jitka - Šrámek, Vladimír - Suk, Pavel
PY  - 2023
TI  - Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report
JF  - Frontiers in Medicine
VL  - 10
IS  - February 2023
SP  - 1-7
EP  - 1-7
PB  - FRONTIERS MEDIA SA
SN  - 2296858X
KW  - fondaparinux
KW  - pharmacokinetics
KW  - heparin-induced thrombocytopenia
KW  - extracorporeal membrane oxygenation
KW  - pharmacoeconomics
UR  - https://www.frontiersin.org/articles/10.3389/fmed.2023.1112770/full
N2  - Heparin-induced thrombocytopenia is a life-threatening immune-mediated complication of unfractionated heparin therapy. Fondaparinux is a therapeutic alternative, but it has limited evidence for its use in patients on extracorporeal membrane oxygenation (ECMO). We present a series of three adult patients with COVID-19 on ECMO who were diagnosed with heparin-induced thrombocytopenia after 7-12 days of unfractionated heparin treatment and were switched to fondaparinux. Fondaparinux was initiated with an intravenous loading dose of 5 mg, followed by a dose of 2.5 mg subcutaneously every 8-12 h. Dosage was adjusted according to daily measured anti-Xa concentration with a target range of 0.4-0.7 mg/L. The total duration of treatment with fondaparinux and ECMO ranged from 13 to 26 days. One major bleeding episode unrelated to fondaparinux therapy was observed, and the transfusions requirement was also low in all patients. The ECMO circuit was changed once in each patient. This series provides a deep insight into the use of fondaparinux over an extended period of time in patients on ECMO. Based on the presented data, fondaparinux can be considered a reasonable and affordable anticoagulant in patients without a high risk of bleeding.
ER  -

RYCHLÍČKOVÁ, Jitka, Vladimír ŠRÁMEK a Pavel SUK. Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report. \textit{Frontiers in Medicine}. Lausanne: FRONTIERS MEDIA SA, 2023, roč.~10, February 2023, s.~1-7. ISSN~2296-858X. Dostupné z: https://dx.doi.org/10.3389/fmed.2023.1112770.

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