IBCC Episode 81 - Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudin

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss anticoagulation, covering unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, argatroban, and bivalirudin. They delve into the basic science of heparin, its mechanism of action involving antithrombin III, and the differences between unfractionated heparin, LMWH, and fondaparinux. The hosts explore the choice of agents, comparing their advantages and disadvantages, including the risk of heparin-induced thrombocytopenia (HIT). They discuss risk assessment for anticoagulation, dosing and monitoring of unfractionated heparin, and the complexities of heparin resistance, differentiating between true and pseudo resistance. The podcast further covers dosing and monitoring of LMWH, fondaparinux, and direct thrombin inhibitors like argatroban and bivalirudin, highlighting practical considerations and potential pitfalls in their use in the ICU.