{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:07:03Z","timestamp":1779304023269,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["FNOs\/2024"],"award-info":[{"award-number":["FNOs\/2024"]}],"id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anticoagulation during extracorporeal membrane oxygenation (ECMO) might still lead to severe bleeding complications. Heparin is the most frequently used anticoagulant, but novel drugs could be promising. Argatroban is a new alternative to heparin. To date, no robust studies have confirmed the clear superiority of argatroban (AG) over heparin, although it has some advantages and may be safer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>An observational study was conducted in all adult veno\u2010venous ECMO patients with COVID\u201019\u2010associated acute respiratory distress syndrome admitted to the University Hospital Ostrava (<jats:italic>n<\/jats:italic>\u2009=\u200963). They were anticoagulated with heparin in the first period and with AG in the second period, targeting the same activated partial thromboplastin time (aPTT; 45\u201360\u2009s). Bleeding complications requiring transfusion and life\u2010threatening bleeding events were evaluated. The primary objective was to compare heparin and AG in terms of bleeding, transfusion requirements and mortality\u2010related bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total time on ECMO per patient was 16\u2009days with an in\u2010hospital mortality of 55.6%. The red blood cell consumption in the AG group (median 2.7 transfusions\/week) was significantly lower than in the heparin group (median 4.2 transfusions\/week, <jats:italic>p<\/jats:italic>\u2009=\u20090.011). Life\u2010threatening bleeding complications were higher in the heparin group compared to the AG group (35.7% vs. 10.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.035<jats:styled-content>),<\/jats:styled-content> and mortality\u2010related bleeding complications were also higher in the heparin group (21.4% vs. 2.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.032).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Argatroban is an interesting alternative to heparin with less bleeding, less need for red blood cell transfusions and improved safety of ECMO with less mortality\u2010related bleeding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.13102","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:43:19Z","timestamp":1728362599000},"page":"75-81","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A safety comparison of heparin and argatroban 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