A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support

As 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 for 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 ventricular 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.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

This review summarizes ten studies of bivalirudin use during extracorporeal membrane oxygenation and five during ventricular assist device support, appraising the direct thrombin inhibitor's off-label role as an alternative to heparin in adult and pediatric mechanical circulatory support.

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