Abstract 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 MoreAbstract The antiphospholipid syndrome (APS) is a complex autoimmune disease that causes a state of hypercoagulability that can result in recurrent venous and arterial thromboses. APS may lead to cardiac..
Read MoreAbstract Background Cardiac surgery with cardiopulmonary bypass (CPB) requires precise hemostasis management to limit postoperative bleeding. Fibrinogen, platelet count, and pro-coagulant factors guide transfusion decisions, yet Clauss fibrinogen measurement during..
Read MoreAbstract Introduction Due to anticoagulation during Extracorporeal Membrane Oxygenation (ECMO), patients face a higher risk of bleeding. This study aimed to assess the correlation between anticoagulation assays and hemorrhage in..
Read MoreAbstract Background and Aims To date, thromboelastometry has not been investigated as an assay to monitor profound heparin anticoagulation, such as is required for a safe cardiopulmonary bypass (CPB). The..
Read MoreAbstract Purpose Tissue factor pathway inhibitor (TFPI) is an intrinsic anticoagulant factor, and its plasma concentration is elevated by heparin administration. Because several hours are required to return to normal..
Read MoreAbstract Background Controversies exist in anticoagulation practices in extracorporeal membrane oxygenation (ECMO). It is uncertain whether the intensity of anticoagulation affects ECMO outcomes. Objectives To conduct a meta-analysis to determine..
Read MoreAbstract This chapter provides an overview of heparin, including discovery, structure, mechanism of action, and principal use for anticoagulation. For over 100 years, heparin has a central role in prophylaxis..
Read MoreAbstract The activated partial thromboplastin time (APTT) assay is essential for evaluating coagulation. However, prolonged APTT may result from pathological conditions or contamination with unfractionated heparin (UFH), which can occur..
Read MoreAbstract Introduction Heparin induced thrombocytopenia (HIT) with in paediatric population is rare and subsequent anticoagulation management is challenging. Bivalirudin is a viable alternative to heparin for anticoagulating paediatric patients with..
Read MoreAbstract Anticoagulation is mandatory during venoarterial extracorporeal membrane oxygenation (V-A ECMO) flow reduction trials with very low blood flow. Anticoagulation in the ECMO circuit might be intensified with less effect..
Read MoreAbstract Background: Unfractionated heparin (UFH) is the standard anticoagulant during cardiopulmonary bypass (CPB). A clinically relevant subset develops heparin resistance (HR)—failure to reach adequate anticoagulation with usual UFH—raising thrombotic risk..
Read MoreAbstract Heparin is the primary anticoagulant used for cardiopulmonary bypass and requires reversal to prevent postoperative bleeding. Protamine sulfate is the only United States Food and Drug Administration–approved heparin reversal..
Read MoreAbstract Background: Unfractionated heparin (UFH) is the standard anticoagulant during cardiopulmonary bypass (CPB). A clinically relevant subset develops heparin resistance (HR)—failure to reach adequate anticoagulation with usual UFH—raising thrombotic risk..
Read MoreAbstract Objective: To compare the effects of intraoperative cell salvage (ICS) and preoperative autologous blood donation (PABD) on postoperative coagulation and platelet function in patients undergoing cardiac surgery, and to..
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