Students Research in Progress
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Bivalirudin is a direct thrombin inhibitor anticoagulant that can be used as an alternative agent for patients who are heparin resistant or diagnosed with heparin induced thrombocytopenia. Unfractionated Heparin (UFH) resistance may be seen in neonates and infants due to inability to achieve desired anti-Xa levels despite high UFH doses. Bivalirudin doses have been described in the literature, however to our knowledge there is limited data on the initial dose based on pediatric age groups which may decrease the time to achieve the desired activated prothrombin time (aPTT).
Research Question or Hypothesis: Is there an optimal bivalirudin dose to achieve desired levels based on pediatric age groups and how does it compare to UFH and its cost?
Study Design: A retrospective review evaluating twelve patients who received bivalirudin between October 1, 2021 and October 1, 2022.
Methods: Conduct an evaluation on pediatric patients receiving bivalirudin in the intensive care units at the institution. Data was obtained using the electronic health record. Inclusion criteria: ages 0 to 18 years old and initiation of bivalirudin while admitted to the ICU. Patients on extracorporeal membrane oxygenation were excluded. Information to be collected: age at initiation of therapy, indication of therapy, dose, serum creatinine, time on bivalirudin and on UFH, aPTT, aPTT hepzyme, anti-Xa levels, and total amount of bivalirudin and heparin utilized,. The primary outcome is to assess the duration in which desired levels were subtherapeutic or supratherapeutic for bivalirudin and UFH. Secondary outcomes is to assess the bivalirudin dose required to achieve the therapeutic range and conduct a cost analysis. IRB approval was not deemed necessary for this medication use evaluation.
Results: Results and analysis are forthcoming and will be presented within poster.
Conclusion: Conclusion forthcoming and will be presented within poster.
Presenting Author
Vivian Ho Bachelor of Art in Biology, MBACook Children's Medical Center
Authors
Olga Rodriguez Pharm.D, BCPPS
Cook Children's Medical Center