ReviewSage open pediatrics
Bivalirudin as an Alternative to Heparin in Pediatric Cardiac Procedures: Evidence, Challenges, and Future Directions.
Review in Sage open pediatrics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Unfractionated heparin remains the standard anticoagulant for pediatric cardiac procedures, but its drawbacks in children are hard to ignore. Because it works through antithrombin, its effect is unpredictable, dosing is difficult to titrate, and it carries the risk of heparin-induced thrombocytopenia (HIT). Bivalirudin, a direct thrombin inhibitor, inhibits thrombin without needing antithrombin. The pediatric evidence, though, is thin. Beyond one cardiac surgery trial and a few catheterization studies, most work comes from ECMO, along with growing use in pediatric ventricular assist device (VAD) support, where direct thrombin inhibitors have replaced heparin and now feature in society guidance. These studies show bivalirudin is feasible and predictable, but not that it consistently beats heparin. For now, its clearest role is in children who cannot tolerate heparin or whose anticoagulation is unstable. The field needs multicenter randomized trials, agreed-upon protocols, and monitoring built for children.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.