RecruitingPhase 2NCT05959252

BivaLirudin versUS Heparin in Extracorporeal Membrane Oxygenation

BivaLirudin versUS Heparin in ECMO - A Registry-embedded, Randomised, Open Label, Feasibility Trial Comparing Two Anticoagulation Strategies in Patients on Extracorporeal Membrane Oxygenation (ECMO)


Sponsor

Sydney Local Health District

Enrollment

80 participants

Start Date

May 1, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this open label randomised clinical trial is to compare Bivalirudin versus Heparin for anticoagulation in patients requiring extracorporeal membrane oxygenation support. The main question it aims to answer are include the ability to maintain anticoagulation within defined therapeutic range, bleeding and thrombotic complications and a comparison of the total cost of anticoagulation care. Participants will be randomised to either anticoagulation with Bivalirudin or anticoagulation with Unfractionated Heparin.


Eligibility

Min Age: 18 Years

Inclusion Criteria3

  • Patients receiving ECMO
  • Age: 18 years or older
  • Ability to randomise the patient within 4 hours of ECMO support initiation

Exclusion Criteria8

  • Post-cardiotomy ECMO patients
  • Contraindication to heparin or bivalirudin at time of randomisation e.g., active bleeding
  • Heparin induced thrombotic thrombocytopenia syndrome
  • Where the patient is expected to be disconnected from ECMO in the next day after cannulation.
  • Limitations of care put in place either through patient wishes or the treating medical teams
  • Other reason where the treating physician deems the study is not in the patient's best interest
  • Patients who are suspected or confirmed to be pregnant
  • Inherited bleeding or thrombotic disorders, Systemic Lupus Erythematosus patients

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Interventions

DRUGUnfractionated heparin

Unfractionated Heparin protocol with target anti-Xa of 0.3-0.5 IU/mL

DRUGBivalirudin

Bivalirudin protocol with target aPTT 50-70 seconds


Locations(1)

Royal Prince Alfred Hospital

Sydney, New South Wales, Australia

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NCT05959252


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