{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:29:45Z","timestamp":1787621385591,"version":"build-2736575974"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Activated partial thromboplastin time (aPTT) is the primary test used to monitor intravenous (IV) direct thrombin inhibitors (DTIs) but has many limitations. The plasma diluted thrombin time (dTT) has shown better correlation with DTI levels than aPTT. This study compared dose-response curves for dTT and aPTT in pediatric patients receiving argatroban and bivalirudin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of pediatric patients treated with argatroban (n\u2005=\u200545) or bivalirudin (n\u2005=\u200514) monitored with dTT and aPTT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The dTT assay was calibrated to report DTI concentrations in \u00b5g\/mL for argatroban and bivalirudin with good analytic sensitivity and specificity. The dTT was fivefold more likely to show a stable dose-response slope than the aPTT (P\u2005&amp;lt;\u2005.0002; odds ratio, 4.9). For patients in whom both dTT and aPTT showed a significant correlation between dose and assay results, dTT had a higher average correlation factor compared with aPTT (P\u2005=\u2005.007). Argatroban dose-response slopes showed more inter- and intrapatient variation than bivalirudin (dose-response slope coefficient of variation, 132% vs 52%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The dTT assay was more likely to show a stable dose response and have a stronger correlation with DTI dose than aPTT. Argatroban shows more variation in dose response than bivalirudin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqac131","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T17:15:42Z","timestamp":1663348542000},"page":"60-68","source":"Crossref","is-referenced-by-count":26,"title":["Monitoring Direct Thrombin Inhibitors With Calibrated Diluted Thrombin Time vs Activated Partial Thromboplastin Time in Pediatric Patients"],"prefix":"10.1093","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-0623","authenticated-orcid":false,"given":"Rida A","family":"Hasan","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, WA , USA"},{"name":"Division of Pediatric Hematology\/Oncology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Pak","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa Jefferis","family":"Kirk","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M","family":"Friedland-Little","sequence":"additional","affiliation":[{"name":"Divison of Pediatric Cardiology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne L","family":"Chandler","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, WA , USA"},{"name":"Department of Laboratories, Seattle Children\u2019s Hospital , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"2023010721554698500_CIT0001","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1345\/aph.1D066","article-title":"Direct thrombin inhibitors for anticoagulation","volume":"38","author":"Nutescu","year":"2004","journal-title":"Ann Pharmacother."},{"key":"2023010721554698500_CIT0002","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1177\/0885066616656333","article-title":"Bivalirudin for alternative anticoagulation in extracorporeal membrane oxygenation: a systematic review","volume":"32","author":"Sanfilippo","year":"2017","journal-title":"J Intensive Care Med."},{"key":"2023010721554698500_CIT0003","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1097\/PCC.0000000000002384","article-title":"Evaluation of bivalirudin as an alternative to heparin for systemic anticoagulation in pediatric extracorporeal membrane oxygenation","volume":"21","author":"Hamzah","year":"2020","journal-title":"Pediatr Crit Care Med."},{"key":"2023010721554698500_CIT0004","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1097\/CCM.0000000000005033","article-title":"Comparison of bivalirudin versus heparin for maintenance systemic anticoagulation during adult and pediatric extracorporeal membrane oxygenation","volume":"49","author":"Seelhammer","year":"2021","journal-title":"Crit Care Med."},{"key":"2023010721554698500_CIT0005","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1097\/CCM.0000000000004944","article-title":"Comparison of anticoagulation strategies in patients requiring venovenous extracorporeal membrane oxygenation: heparin versus bivalirudin","volume":"49","author":"Rivosecchi","year":"2021","journal-title":"Crit Care Med."},{"key":"2023010721554698500_CIT0006","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/aor.13758","article-title":"Is anticoagulation with bivalirudin comparable to heparin for pediatric extracorporeal life support? 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