Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with severe cardiac or respiratory failure, but it is associated with a high risk of thrombotic and bleeding..
Read MoreAbstract Objectives This systematic review and meta-analysis aimed to evaluate clinical outcomes associated with different systemic heparin protocols (conservative v standard intensity) during extracorporeal membrane oxygenation (ECMO) support. Included studies comprised both..
Read MoreAbstract Background Heparin-induced thrombocytopenia (HIT) in patients who undergo cardiac surgery presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence..
Read MoreAbstract Introduction Bleeding and clotting phenotypes are common in patients supported with Extracorporeal Membrane Oxygenation (ECMO) and are associated with increased mortality. However, tools to distinguish bleeding from clotting phenotypes..
Read MoreAbstract Factor XIII (FXIII) contributes to clot stability and reduces clot susceptibility to lysis through fibrin cross-linking. Standard coagulation tests like prothrombin time and activated partial thromboplastin time do not..
Read MoreAbstract Extracorporeal membrane oxygenation (ECMO) has increasingly been used in patients with refractory severe cardiorespiratory failure in recent years. The use of ECMO necessitates anticoagulation as blood passes through an..
Read MoreAbstract Heparin-induced thrombocytopenia (HIT) in patients on mechanical circulatory support (MCS) prior to lung transplantation poses a unique challenge of balancing thrombotic versus hemorrhagic complications. An alternative method of anticoagulation..
Read MoreAbstract Extracorporeal life support, such as hemodialysis, often face the risk of blood coagulation, where systemic anticoagulation with heparin is routinely administered. However, this strategy is contraindicated in patients at..
Read MoreAbstract Factor XII (FXII) is a central mediator at the intersection of coagulation, fibrinolysis, inflammation, and immunity. It is activated upon contact with negatively charged surfaces, triggering the intrinsic coagulation..
Read MoreAbstract Background: Heparin is the standard anticoagulant used during cardiopulmonary bypass (CPB). However, there are problems with heparin, including immunogenicity and variability of effect, that make a search for an..
Read MoreAbstract The past year has yielded important advances in coagulation and transfusion practice across cardiothoracic and vascular care. Patient blood management remains central, with growing evidence supporting restrictive transfusion thresholds,..
Read MoreAbstract Disseminated intravascular coagulation (DIC) has long been described as a catastrophic systemic activation of coagulation with suppressed anticoagulant and fibrinolytic pathways, culminating in macro- and microvascular thrombosis, hypoperfusion, and..
Read MoreAbstract Anticoagulants are widely used to prevent and treat thrombotic disorders, and continuous advances have refined their efficacy and safety. Beyond their established anticoagulant function, growing evidence indicates that some..
Read MoreAbstract Background Monitoring of unfractionated heparin (UFH) in critically ill patients is challenging due to disease-related alterations of the coagulation system, directly affecting conventional laboratory tests, including activated partial thromboplastin..
Read MoreAbstract Objectives To develop and validate, a real-time algorithm to individualize unfractionated heparin (UFH) dosing based on activated clotting time (ACT) dynamics in cardiac procedures with or without cardiopulmonary bypass..
Read MoreAbstract Objectives: The parenteral anticoagulant bivalirudin has favorable safety and efficacy outcomes compared with unfractionated heparin (UFH) in pediatric patients requiring extracorporeal membrane oxygenation (ECMO), and is frequently monitored using..
Read MoreAbstract Background: Although unfractionated heparin (UFH) has traditionally been used for anticoagulation during extracorporeal membrane oxygenation (ECMO), bivalirudin may be preferred due to fewer complications. A prior medication use evaluation..
Read MoreAbstract Clinically significant bleeding is a common complication of extracorporeal membrane oxygenation (ECMO), with bleeding observed in upwards of 40% of patients. Bleeding is strongly associated with systemic anticoagulation, which..
Read MoreAbstract Objectives Clinical practice in anticoagulation management, particularly in heparin administration, monitoring, reversal and haemostasis, is known to differ significantly. To better characterize this variability, we conducted a Europe-wide survey..
Read MoreAbstract Objectives Clinical practice in anticoagulation management, particularly in heparin administration, monitoring, reversal and haemostasis, is known to differ significantly. To better characterize this variability, we conducted a Europe-wide survey..
Read MoreAbstract Introduction Regional citrate anticoagulation (RCA) is the recommended first-line strategy for continuous renal replacement therapy (CRRT) circuits. Acute kidney injury is common in patients undergoing venoarterial extracorporeal membrane oxygenation..
Read MoreAbstract Hemostasis depends on the coordinated interaction between platelets, coagulation factors, endothelium, and shear forces. Current point-of-care (POC) assays evaluate isolated components of haemostasis or operate under nearly static conditions,..
Read MoreAbstract Objective: To evaluate whether systemic anticoagulation therapy affects the survival of adult patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) for acute respiratory distress syndrome (ARDS). Design: Multicenter retrospective study...
Read MoreAbstract Heparin is among the most widely used anticoagulants worldwide, with an annual market of ∼$4 billion. It also poses potential bleeding risks (0.5–5%), occasionally life-threatening, necessitating heparin reversal agents...
Read MoreAbstract Since the use of heparin reversed by protamine is the gold standard for anticoagulation during cardiopulmonary bypass (CPB), a documented allergy to protamine represents a serious challenge for cardiac..
Read MoreAbstract Background: Andexanet alfa, a Gla-domainless mutant factor Xa (GDXa), reverses oral FXa inhibitors but can cause severe heparin resistance during cardiopulmonary bypass (CPB). Antithrombin (AT) supplementation may mitigate this..
Read MoreAbstract Background Protamine is administered to reverse unfractionated heparin (UFH) after cardiopulmonary bypass (CPB), but dosing strategies—typically based on protamine-to-heparin (P:H) ratios—vary, and the minimal effective dose remains unclear. Reversal..
Read MoreAbstract Objective Heparin-induced thrombocytopenia (HIT) is a serious concern in cardiac surgery, as heparin use in the at-risk patient can lead to devastating thrombosis. Management strategies for patients with confirmed..
Read MoreAbstract Background Protamine has a more difficult side-effect profile. Circulatory collapse has been reported as a result of acute pulmonary artery spasm caused by complement cascade activation by large heparin–protamine..
Read MoreAbstract Terada et al. presented an important study on the dynamic relationship between plasma fibrinogen concentration and functional clot strength after cardiopulmonary bypass (CPB). Their findings underscore the multifactorial nature of..
Read More












