{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T18:11:18Z","timestamp":1788718278875,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministry of Health Czech Republic","award":["FNOs\/2025"],"award-info":[{"award-number":["FNOs\/2025"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Unfractionated heparin has long been considered the standard anticoagulation in ECMO, despite some pitfalls such as heparin resistance, heparin induced thrombocytopenia (HIT), etc Recently, some centres started to increasingly use argatroban for this purpose, typically using activated partial thromboplastin time (aPTT) for its monitoring. Direct monitoring of the efficacy of argatroban using Anti-IIa is not yet an established method, although it might be more appropriate as it targets the same pathway.An observational study was performed in adult veno-venous ECMO patients hospitalized with SARS-CoV-2 infection anticoagulated with argatroban to an aPTT target of 40-60 s and Anti-IIa target of 0.4\u20130.6 \u00b5g\/mL. Bleeding and thrombotic complications were monitored.Forty-four VV ECMO patients were included, with an overall hospital mortality of approx. 50%. No life-threatening thrombotic events were recorded. The risk of bleeding complications significantly increased with aPTT above 52.7 s and with Anti-IIa values over 0.78 \u00b5g\/mL. Using the above cut-offs for both the aPTT and Anti-IIa and their combination, the negative predictive value for bleeding was approximately 90%.It seems that the generally recommended limits for Anti-IIa of 1.5 \u00b5g\/mL may be high. However, further data are needed to confirm lower limits.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>retrospectively registered in ClinicalTrials.gov, NCT06038682.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296251341315","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T10:25:58Z","timestamp":1747823158000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Activated Partial Thromboplastin Time and Anti-IIa Monitoring in Argatroban Anticoagulation in COVID-19 Patients on Venovenous Extracorporeal Membrane Oxygenation"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9770-1433","authenticated-orcid":false,"given":"Filip","family":"Bur\u0161a","sequence":"first","affiliation":[{"name":"University of Ostrava"},{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Frelich","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sklienka","sequence":"additional","affiliation":[{"name":"University of Ostrava"},{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"N\u011bmcov\u00e1","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzana","family":"Ku\u010derov\u00e1","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ond\u0159ej","family":"Jor","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Romanov\u00e1","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e9la","family":"Kond\u00e9","sequence":"additional","affiliation":[{"name":"VSB \u2013 Technical University of Ostrava"},{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Jano\u0161ek","sequence":"additional","affiliation":[{"name":"University of Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u0159\u00ed","family":"Sagan","sequence":"additional","affiliation":[{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"M\u00e1ca","sequence":"additional","affiliation":[{"name":"University of Ostrava"},{"name":"University Hospital Ostrava"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03463-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06805-y"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06593-x"},{"key":"e_1_3_3_5_2","article-title":"A safety comparison of heparin and argatroban anticoagulation in veno-venous extracorporeal membrane oxygenation with a focus on bleeding","author":"Bur\u0161a F","unstructured":"Bur\u0161a F, M\u00e1ca J, Sagan J, et al. A safety comparison of heparin and argatroban anticoagulation in veno-venous extracorporeal membrane oxygenation with a focus on bleeding. Transfus Med. 2025 Feb;35(1):75-81. doi:https:\/\/doi.org\/10.1111\/TME.1310","journal-title":"Transfus Med"},{"issue":"12","key":"e_1_3_3_6_2","article-title":"Anticoagulation management during extracorporeal membrane oxygenation-A mini-Review","volume":"58","author":"Bur\u0161a F","year":"2022","unstructured":"Bur\u0161a F, Sklienka P, Frelich M, Jor O, Ekrtov\u00e1 T, M\u00e1ca J. Anticoagulation management during extracorporeal membrane oxygenation-A mini-Review. Medicina (Kaunas). 2022;58(12):1783. doi:https:\/\/doi.org\/10.3390\/MEDICINA58121783","journal-title":"Medicina (Kaunas)"},{"key":"e_1_3_3_7_2","article-title":"Argatroban anticoagulation for adult extracorporeal membrane oxygenation: A systematic review","author":"Geli J","unstructured":"Geli J, Capoccia M, Maybauer DM, Maybauer MO. Argatroban anticoagulation for adult extracorporeal membrane oxygenation: A systematic review. J Intensive Care Med. 2022 Apr;37(4):459-471. doi:https:\/\/doi.org\/10.1177\/0885066621993739","journal-title":"J Intensive Care Med"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1597297"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","unstructured":"Favaloro EJ Adcock D Lippi G. CE Update Pre-analytical variables in coagulation testing associated with diagnostic errors in hemostasis corresponding author. Laboratory Medicine 2012;43(2):1-10. doi:https:\/\/doi.org\/10.1309\/LM749BQETKYPYPVM","DOI":"10.1309\/LM749BQETKYPYPVM"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/labmed\/lmx050"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2019.011001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13757"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13757"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001652"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2022.11.014"},{"key":"e_1_3_3_16_2","unstructured":"BARC: New Bleeding Definitions Aim to Standardize Trial Endpoints | tctmd.com. Accessed October 4 2024. https:\/\/www.tctmd.com\/news\/barc-new-bleeding-definitions-aim-standardize-trial-endpoints"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004787"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201605-364SR"},{"key":"e_1_3_3_19_2","first-page":";27","article-title":"Caution in using the activated partial thromboplastin time to monitor argatroban in COVID-19 and vaccine-induced immune thrombocytopenia and thrombosis (VITT)","author":"Guy S","year":"2021","unstructured":"Guy S, Kitchen S, Makris M, Maclean RM, Saccullo G, Vanveen JJ. Caution in using the activated partial thromboplastin time to monitor argatroban in COVID-19 and vaccine-induced immune thrombocytopenia and thrombosis (VITT). Clin Appl Thromb Hemost. 2021;27:10760296211066945. doi:https:\/\/doi.org\/10.1177\/10760296211066945","journal-title":"Clin Appl Thromb Hemost"},{"key":"e_1_3_3_20_2","article-title":"Recommendations on the use of anticoagulants for the treatment of patients with heparin-induced thrombocytopenia in Switzerland","volume":"150","author":"Alberio L","year":"2020","unstructured":"Alberio L, Angelillo-Scherrer A, Asmis L, et al. Recommendations on the use of anticoagulants for the treatment of patients with heparin-induced thrombocytopenia in Switzerland. Swiss Med Wkly. 2020;150:w20210. doi:https:\/\/doi.org\/10.4414\/smw.2020.20210","journal-title":"Swiss Med Wkly"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-1109-0"},{"key":"e_1_3_3_22_2","article-title":"951: Comparison of aPTT versus anti-IIa monitoring for argatroban dosing","volume":"41","author":"Vu N","year":"2013","unstructured":"Vu N, Jaynes E, Hanigan S, Pogue K, Dorsch M, Alaniz C. 951: Comparison of aPTT versus anti-IIa monitoring for argatroban dosing. Crit Care Med. 2013;41(12):A239. doi:https:\/\/doi.org\/10.1097\/01.CCM.0000440189.69912.21","journal-title":"Crit Care Med"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2022.03.032"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001208"},{"issue":"1","key":"e_1_3_3_25_2","first-page":"1","article-title":"Extracorporeal membrane oxygenation for COVID-19: A systematic review and meta-analysis","volume":"25","author":"Ramanathan K","year":"2021","unstructured":"Ramanathan K, Shekar K, Ling RR, et al. Extracorporeal membrane oxygenation for COVID-19: A systematic review and meta-analysis. Crit Care. 2021;25(1):1-11. doi:https:\/\/doi.org\/10.1186\/S13054-021-03634-1\/TABLES\/3","journal-title":"Crit Care"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32008-0"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249854"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13520"},{"issue":"3","key":"e_1_3_3_29_2","article-title":"Safety of low-dose anticoagulation in extracorporeal membrane oxygenation using the Permanent Life Support System: a retrospective observational study","volume":"40","author":"Song K","year":"2023","unstructured":"Song K, Kim JB. Safety of low-dose anticoagulation in extracorporeal membrane oxygenation using the Permanent Life Support System: a retrospective observational study. Journal of Yeungnam Medical Science. 2023;40(3):276-282. doi:https:\/\/doi.org\/10.12701\/JYMS.2023.00339","journal-title":"Journal of Yeungnam Medical Science"},{"key":"e_1_3_3_30_2","article-title":"Recommendations on the use of anticoagulants for the treatment of patients with heparin-induced thrombocytopenia in Switzerland","volume":"24","author":"Alberio L","year":"2020","unstructured":"Alberio L, Angelillo-Scherrer A, Asmis L, et al. Recommendations on the use of anticoagulants for the treatment of patients with heparin-induced thrombocytopenia in Switzerland. Swiss Med Wkly. 2020 Apr 24;150:w20210. doi:https:\/\/doi.org\/10.4414\/smw.2020.20210","journal-title":"Swiss Med Wkly"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-005-0962-7"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32008-0"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202105-1145LE"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002644"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251341315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296251341315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251341315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:05:10Z","timestamp":1777385110000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296251341315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":33,"alternative-id":["10.1177\/10760296251341315"],"URL":"https:\/\/doi.org\/10.1177\/10760296251341315","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,21]]},"article-number":"10760296251341315"}}