RYCHLÍČKOVÁ, Jitka, Vladimír ŠRÁMEK and 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, vol. 10, February 2023, p. 1-7. ISSN 2296-858X. Available from: https://dx.doi.org/10.3389/fmed.2023.1112770.
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Basic information
Original name Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report
Authors RYCHLÍČKOVÁ, Jitka (203 Czech Republic, guarantor, belonging to the institution), Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution) and Pavel SUK (203 Czech Republic, belonging to the institution).
Edition Frontiers in Medicine, Lausanne, FRONTIERS MEDIA SA, 2023, 2296-858X.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30104 Pharmacology and pharmacy
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 3.900 in 2022
RIV identification code RIV/00216224:14110/23:00130657
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3389/fmed.2023.1112770
UT WoS 000945810700001
Keywords in English fondaparinux; pharmacokinetics; heparin-induced thrombocytopenia; extracorporeal membrane oxygenation; pharmacoeconomics
Tags 14110122, 14110516, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 27/4/2023 10:17.
Abstract
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.
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