Table 3.
Demographic, Clinical, and Complication Data for Patients on Therapeutic Bivalirudin Anticoagulation During ECMO Support
| Demographic | Non-COVID(n = 23) | COVID(n = 19) | p Value |
|---|---|---|---|
| Age (y), median (IQR) | 48 (28-52) | 40 (33-49) | 0.75 |
| Females, n (%) | 11 (48) | 6 (32) | 0.29 |
| Weight (kg), median (IQR) | 87.1 (68.2-99.8) | 98.0 (87.2-110.1) | 0.04 |
| Obese, n (%) | 12 (52) | 14 (74) | 0.21 |
| Hx. diabetes mellitus, n (%) | 2 (9) | 5 (26) | 0.21 |
| Hx. chronic kidney disease, n (%) | 3 (13) | 0 (0) | 0.24 |
| Hx. cardiovascular disease | 10 (44) | 5 (26) | 0.34 |
| Hx. chronic respiratory disease | 10 (44) | 3 (16) | 0.09 |
| Prior aspirin use | 3 (13) | 2 (11) | 1.00 |
| Aspirin while on ECMO | 3 (13) | 1 (5) | 0.61 |
| Prior anticoagulation use | 2 (9) | 0 (0) | 0.49 |
| In-hospital mortality | 5 (22) | 3 (16) | 0.71 |
| Mortality on ECMO | 3 (13) | 3 (16) | 1.00 |
| Renal replacement therapy after ECMO initiation, n (%) | 6 (26) | 2 (11) | 0.20 |
| Clinical | |||
| Total time on ECMO (h), median (IQR) | 167 (136-351) | 263 (165-525) | 0.16 |
| Total time on bivalirudin (h), median (IQR) | 136 (79-260) | 255 (160-502) | 0.03 |
| Time to goal aPTT (h), median (IQR) | 16.4 (5.7-26.5) | 12.1 (7.79-16.4) | 0.87 |
| Percentage of aPTT measurements in goal (%), median (IQR) | 74.0 (59.5-81.8) | 86.0 (80.1-90) | <0.01 |
| Median daily bivalirudin rate (μg/kg/min), Median (IQR) | 2.4 (1.7-3.3) | 3.1 (2.3-5.2) | 0.05 |
| Highest daily rate (μg/kg/min), median (IQR) | 3.8 (2.5-5) | 5 (3.7-7.5) | 0.03 |
| Total cost of bivalirudin (US dollars) | 12,507 (3,411-19,329) | 28,425 (13,075-46,617) | 0.01 |
| ICU length of stay (d), median (IQR) | 20 (8-28.5) | 29 (16.8-36.25) | 0.04 |
| Hospital length of stay (d), median (IQR) | 24 (13-38.5) | 29.5 (26-35.3) | 0.17 |
| Complications | |||
| Bleeding, n (%) | 6 (26) | 4 (21) | 0.70 |
| Intracranial or intraocular bleeding, n (%) | 0 (0) | 0 (0) | 1.00 |
| Gastrointestinal bleeding, n (%) | 5 (22) | 3 (16) | 0.63 |
| Deep venous thrombosis, n (%) | 9 (39) | 11 (58) | 0.23 |
Abbreviations: aPTT, activated partial thromboplastin time; COVID-19, Coronavirus 2019; ECMO, extracorporeal membrane oxygenation; Hx. history of:ICU, intensive care unit; IQR, interquartile range.