Table 1.

Bivalirudin anticoagulation management flowsheet tracked over course of treatment

Date	Time	aPTT (s)	aPTT goal (s)	Dosing (mg/kg/hour)	∆ in dosing	TEG		INR
						R (min)	K (min)
25 April	18:32	23.3		0.15		4.2	1.6	1
26 April	01:51	62.6	40–60	0.15	↓ 20%
26 April	05:19		50–70	0.12	↑ 20%
26 April	09:12	44.2	50–70	0.15	↑ 20%
26 April	15:42	45.6	50–70	0.18	0%
26 April	17:32	45.5	50–70	0.18	0%
26 April	21:49	48	50–70	0.234	0%
27 April	01:00	49.8	50–70	0.234	↑ 20%
27 April	03:54					9.5	1.1	1.6
27 April	09:55	51	50–70	0.28	0%
27 April	16:04	57	50–70	0.28	0%
28 April	03:39	49.1	50–70	0.28	↑ 20%	8	1.3
28 April	10:00	51.5	50–70	0.34	0%
28 April	14:00	54	50–70	0.34	0%
28 April	21:47	54	50–70	0.34	0%
Bivalirudin to be infused into the circuit pre oxygenator
29 April	03:26		60–90	0.34	↑ 20%	9.4	1.2
29 April	05:15	54.1	60–90	0.41	↑ 20%
29 April	09:53	62.8	60–90	0.49	0%
29 April	15:17	56.6	60–90	0.49	↑ 10%
29 April	19:50	61.1	60–90	0.54	0%
29 April	01:24	60.4	60–90	0.54	0%			1.8
30 April	03:57	58.8	60–90	0.54	0%
Multiple fibrin strands noted; bivalirudin to be infused via central line
30 April	11:47	62.7	60–90	0.54	0%
30 April	13:53	61.7	60–90	0.54	↑ 20%
Switched anticoagulation therapy to argatroban due to possible resistance to bivalirudin
1 May	04:54	64.3	60–90	1.76	0%	11.6	2.8
1 May	09:55	56.6	60–90	2.2	↑ 20%
1 May	16:03	84.5	60–90	2.2	0%
1 May	21:39	72.6	60–90	2.2	0%

aPTT, activated partial thromboplastin time; INR, international normalised ratio; TEG, thromboelastography.