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Characteristics Associated with Mortality in 623 Patients Who Received Recombinant Factor VIIa for Bleeding in Cardiac Surgery

Abstract Objectives Activated recombinant factor VII (rFVIIa) has been used to treat cardiac surgical bleeding in an off-label manner. Due to the high risk of mortality with ongoing hemorrhage, assessing..

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Dose-Dependent Changes in Clot Firmness in Thromboelastometry After Administration of Fibrinogen Concentrate: A Retrospective Observational Study

Abstract Introduction Viscoelastic point-of-care diagnostics are crucial in cardiac surgery. In the FIBTEM assay of rotational thromboelastometry (ROTEM), guidelines suggest target maximum clot firmness values to reduce perioperative bleeding. The..

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The TEG6s-Derived R ratio accurately reflects the anti-Xa level after cardiac surgery: A proof-of-concept study

Abstract Introduction In the postoperative intensive care setting after cardiac surgery with cardiopulmonary bypass (CPB), particularly in patients requiring continued anticoagulation for prosthetic devices such as mechanical valves or extracorporeal..

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Silk-based multilayer coatings for anticoagulation and durability improvement in ECMO hollow fiber membranes

Abstract In clinical extracorporeal membrane oxygenation (ECMO), prolonged blood residence time in oxygenators can lead to thrombus formation and complications. Heparin-based bioactive coatings are commonly used for anticoagulation, but prolonged..

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Influence of High-Dose Heparin on CT EXTEM of ROTEM Sigma and ROTEM Delta During Cardiopulmonary Bypass

Abstract Transfusion management during cardiac surgery is commonly guided by algorithms using viscoelastic tests such as Rotational Thromboelastometry (ROTEM). Recently, the ROTEM Sigma, a new device developed as a fully..

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Uncovering digital overdiagnosis – Quantification and mitigation using clinical trajectories: Heparin-induced thrombocytopenia use case

Abstract Objective Overdiagnosis occurs when abnormalities meeting diagnostic criteria would remain asymptomatic if undiagnosed. Cases initially identified through digital diagnostic tools but later recognised as overdiagnosis are referred to as..

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Covalent Organic Framework-Based Porous Anticoagulant Materials for Extracorporeal Blood Circulation

Abstract Preventing coagulation during extracorporeal blood circulation is critical for clinical treatments. Developing anticoagulant materials for key components can reduce reliance on systemic anticoagulants and improve safety. However, such materials..

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Management of Amniotic Fluid Embolism (AFE) using anticoagulation-free ECMO

Abstract Amniotic fluid embolism (AFE) is a critical obstetric complication characterized by the entry of amniotic fluid and its components into maternal circulation during parturition, leading to acute cardiopulmonary failure,..

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Effectiveness and safety of bivalirudin anticoagulation therapy in adult patients receiving extracorporeal membrane oxygenation: A systematic review and meta-analysis

Abstract Background:  Compared to heparin, there is limited evidence of the benefits of bivalirudin in the patients with extracorporeal membrane oxygenation (ECMO). Methods:  We searched for studies comparing bivalirudin anticoagulation..

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Von Willebrand factor in Ecmo: a dynamic modulator of hemorrhage and thrombosis

Abstract Von Willebrand factor (vWF) orchestrates hemostasis through platelet activation, factor VIII stabilization, and inflammatory modulation, with emerging evidence highlighting its shear-dependent conformational dynamics as a critical regulator of thrombus..

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Anticoagulation Monitoring During Extracorporeal Membrane Oxygenation: A Narrative Review

Abstract The advancement of  has introduced a new dimension to managing patients who do not respond to conventional treatment of severe .  (ECMO) is a specialized temporary life support that serves as a..

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Analysis of Risk Factors for Heparin Resistance During Cardiac Surgery: Does Antithrombin Deficiency Cause Heparin Resistance?

Abstract Objectives To determine whether heparin resistance (HR) occurring during  (CPB) is associated with  (antithrombin III) activity. Design Retrospective review of data collected prospectively in a single center. Setting A tertiary referral..

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The impact of antithrombin III supplementation on prognosis during extracorporeal membrane oxygenation: a systematic review and meta-analysis

Abstract Extracorporeal membrane oxygenation (ECMO) is a mechanical circulatory and respiratory support system that facilitates gas exchange and hemodynamic stabilization through an external circuit. ECMO has been increasingly utilized for..

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Monoclonal Antibodies in the Pathogenesis of Heparin-Induced Thrombocytopenia

Abstract Background Heparin-induced thrombocytopenia (HIT) is an immune-mediated platelet disorder caused by antibodies that target complexes of platelet factor 4 (PF4) and heparin. HIT has been characterized as a polyclonal..

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Temporal trends and risk factors for bleeding and thrombosis in pediatric ECMO: A multicenter cohort study

Abstract Introduction Bleeding and thrombosis are major causes of morbidity and mortality in pediatric extracorporeal membrane oxygenation (ECMO), yet their evolving, time-dependent risks remain poorly defined. This study evaluated clinical..

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Residual Heparinization After Cardiac Surgery:A Prospective Observational Study

Abstract Objectives Residual heparinization is a preventable cause of coagulopathy following cardiac surgery. The aim of this work was to assess the proportion of patients with residual heparinization following cardiac..

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Comparison of Two Activated Clotting Time Targets During Cardiac Surgery With Cardiopulmonary Bypass: A Prospective Multicenter Randomized Controlled Trial

Abstract Objectives The present study was designed to investigate the equivalence of two target activated clotting time (ACT) values with regard to packed red blood cell (PRBC) transfusion in patients..

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Heparin-free veno-venous ECMO for airway obstruction: A case report and review of literature

Abstract Rationale:  Life-threatening airway obstructions caused by tumors demand prompt and effective intervention. Traditional surgical methods are often complicated by bleeding risks, especially with the use of anticoagulation during extracorporeal..

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Feasibility and effectiveness of the novel HemoClear microfiltration cell-salvage system in cesarean sections in South Africa

Abstract Objective To test the feasibility and effectiveness of implementing the HemoClear microfiltration cell-salvage system for cesarean sections in South Africa. Methods We conducted a prospective experimental single-arm feasibility study..

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Evaluation of Intraoperative Bivalirudin Anticoagulation in Neonates and Infants Undergoing Arterial Switch Operation on Integrated ECMO-CPB Circuit: A Prospective Study

Abstract Objectives To ascertain the dosage of bivalirudin in neonates and infants undergoing arterial switch operation on integrated extracorporeal membrane oxygenation–cardiopulmonary bypass (CPB) circuit. Design Pilot study. Setting A tertiary..

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Sickle Cell Disease and Cardiopulmonary Bypass: A Multidisciplinary Approach to High-Risk Cardiac Surgery

1. Introduction Sickle Cell Disease (SCD) is a chronic, inherited blood disorder resulting from a single point mutation in the β-globin gene. This mutation leads to the production of hemoglobin..

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Development of Experimental Models of Antithrombin-independent Heparin Resistance Using Platelet Factor 4 and the Effect of Antithrombin in These Models

Abstract Objectives Antithrombin (AT) deficiency is considered the primary cause of heparin resistance (HR); however, some patients with HR have normal AT activity (AT-independent HR). Supplementation with concentrated human AT..

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Anticoagulate the Circuit, Not the Patient: Nitric Oxide Reduces Thrombus Formation During Extracorporeal Carbon Dioxide Removal

Abstract Solutions to reduce the need for systemic anticoagulation during extracorporeal life support would improve safety and utility. The study objective was to evaluate the safety and efficacy of a..

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Anticoagulation during Extracorporeal Membrane Oxygenation (ECMO): A Selective Inhibitor of Activated Factor XII Compared to Heparin in an Ex Vivo…

Abstract Extracorporeal membrane oxygenation (ECMO) is a form of life support for critically ill patients with severe respiratory or cardiac failure. Interactions between patient blood and ECMO biomaterials increase the..

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Comparative Analysis of Thrombosis in ECPella Patients Between Bivalirudin versus Heparin Anticoagulation Strategies

Abstract Objective To review and compare the frequency of thrombus and adverse events in patients treated with heparin or bivalirudin systemic anticoagulation strategies supported on combined venoarterial extracorporeal membrane oxygenation..

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Storage duration of packed red blood cells transfused during veno-venous extracorporeal membrane oxygenation is associated with elevated pulmonary artery pressure…

Abstract Background Veno‑venous extracorporeal membrane oxygenation (VV‑ECMO) is associated with a high transfusion burden. While trials have concluded that red blood cell (RBC) storage does not impact patient morbidity and..

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Managing Coagulation Using the Sonoclot Analyzer in Patients With Disseminated Intravascular Coagulation

Abstract Background Evidence for the effectiveness of the Sonoclot analyzer in improving clinical outcomes in disseminated intravascular coagulation (DIC) is lacking. Objective To evaluate the effectiveness of an algorithm based..

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Intraoperative Autologous Blood Transfusion in Aortic Surgery

Abstract Aortic surgeries are associated with intraoperative blood loss, often requiring allogeneic blood transfusion. Therefore, blood must be viewed as a scarce resource that carries risks and benefits. Many preoperative..

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High-risk pulmonary embolism: the significance and perspectives of pulmonary reperfusion

Abstract Rapid hemodynamic stabilization and restoration of pulmonary perfusion are the cornerstones of treatment for high-risk pulmonary embolism (PE). While all current guidelines recommend systemic thrombolysis (SYS) as the first-line..

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Bloodless lung transplantation: Comparison between 2 central venoarterial extracorporeal membrane oxygenation anticoagulation strategies and their impact on lung transplant outcomes

Abstract Objective To report differences between 2 anticoagulation protocols during venoarterial extracorporeal membrane oxygenation (VA-ECMO) intraoperative support and their effects on outcomes after lung transplantation. Methods We performed a retrospective..

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