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Analysis of the feasibility of a low-anticoagulation strategy in patients undergoing post-cardiotomy extracorporeal membrane oxygenation: a retrospective cohort study

Abstract Background Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients after cardiac surgery; however, anticoagulation management has consistently been challenging. This study aimed to explore the feasibility of a..

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Perioperative management of adult patients undergoing coronary artery bypass grafting and valve surgery: a literature review

Abstract Purpose of review  Coronary artery bypass grafting, revascularization by percutaneous coronary intervention, and heart valve surgery are crucial therapeutic interventions for patients with various cardiovascular diseases. The objective of..

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Normothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Type A Aortic Dissection

Abstract Background Deep hypothermic circulatory arrest is the standard approach for the surgical repair of acute type A aortic dissection. This study aimed to evaluate the feasibility and outcomes of..

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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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Anticoagulant Sulfonate Polyamide/Poly(ether sulfone) Membrane Barrier for Efficient Blood Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is the most important support for patients with severe cardiopulmonary failure. As the key component, the oxygenation membrane has suffered the risk of blood coagulation..

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Investigation of the impact of antithrombin deficiency on the inflammatory response: Results from a single centre cohort study

Abstract Background Antithrombin signalling may exert an anti-inflammatory effect; therefore we hypothesised that individuals with inherited antithrombin deficiency (ATD) may have an altered inflammatory state. Aims To assess the inflammatory..

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Navigating coagulation: Key markers in the first 24 hours of pediatric ECMO

Abstract Background Anticoagulation in pediatric extracorporeal membrane oxygenation (ECMO) presents unique challenges due to developmental hemostasis, coagulation factor production, and response to anticoagulants. This process requires close monitoring to prevent..

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Dual surface modification of polydimethylsiloxane (PDMS) with antithrombin-heparin complex (ATH) and tissue plasminogen activator (t-PA) for enhanced antithrombotic activity

Abstract Medical devices used in contact with blood trigger coagulation and activate platelets leading to thrombotic complications. To prevent these effects, systemic anticoagulants and antiplatelet agents are typically prescribed, but..

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Comparison of Perioperative Outcomes for Transfusion of Hemoconcentrated Bypass Versus Cell Saver Blood in Cardiac Surgical Patients

Abstract Objective Hemoconcentration and cell saver use are blood conservation techniques that are often used in cardiac surgery to salvage the patient's own blood to reduce autologous transfusion. The purpose..

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Evaluation of an aPTT guided versus a multimodal heparin monitoring approach in patients on extra corporeal membrane oxygenation: A retrospective…

Abstract Introduction Bleeding and thrombotic complications are common in extracorporeal membrane oxygenation (ECMO) patients and are associated with increased mortality and morbidity. The optimal anticoagulation monitoring protocol in these patients..

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Fibrinogen levels and bleeding risk in adult extracorporeal cardiopulmonary resuscitation: multicenter observational study subanalysis

Abstract Introduction Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential life-support system in critical care specifically engineered to assist cardiac and respiratory function by externally maintaining blood perfusion and oxygenation..

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Prolonged Use of Extracorporeal Membrane Oxygenators for COVID-19–Associated Acute Respiratory Distress Syndrome: A Retrospective Analysis

Abstract Whether an anticoagulation strategy combining bivalirudin and aspirin during extracorporeal membrane oxygenation (ECMO) would prolong oxygenator use is unknown. No clear data exist on oxygenator life span during prolonged..

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Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery

Abstract Importance  Excessive bleeding is a common and prognostically important complication of cardiac surgery. For bleeding related to coagulation factor deficiency, frozen plasma is the most used therapy. Preliminary trials indicate..

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Inflammatory Responses During Cardiopulmonary Bypass: Mechanisms, Mediators, and Management Strategies

Abstract: Cardiopulmonary bypass (CPB) induces a multifactorial systemic inflammatory response that significantly contributes to postoperative complications such as acute lung injury, renal dysfunction, and increased morbidity. This response is initiated..

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Prothrombotic Microvesicle Generation in Pediatric Cardiopulmonary Bypass: A Pilot Observational Study

Abstract Over 10% of children develop thrombosis after cardiac surgery for congenital heart disease. Children with a single ventricle physiology have the highest risk of thrombosis associated with increased length..

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Principles and Functions of Cardiopulmonary Bypass (CPB).

Cardiopulmonary Bypass (CPB) is one of the most critical advancements in cardiac surgery. It allows the surgical team to operate on a non-beating heart by temporarily taking over the functions..

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Early endovascular reperfusion during extracorporeal support for massive pulmonary embolism

Abstract In massive pulmonary embolism (PE), endovascular therapies and extracorporeal membrane oxygenation (ECMO) are increasingly utilised. However, the impact of combining endovascular therapies with ECMO on shock resolution and clinical recovery remains..

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Variations in thromboelastography levels in blood exposed to membrane oxygenators

Abstract Introduction Thromboelastography (TEG), which indicates hemostatic ability, is useful for monitoring coagulation during extracorporeal circulation (ECC). However, the extent to which TEG levels are independently affected by ECC exposure..

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Theoretical Foundations of Cardiopulmonary Bypass: Bridging Science, Engineering, and Clinical Practice

Introduction: A Heart That Pauses, A Circuit That Lives When the heart is arrested during cardiac surgery, life continues—thanks to cardiopulmonary bypass (CPB). The theoretical underpinnings of CPB stem from..

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Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal

Abstract Extracorporeal carbon dioxide removal (ECCO2R) is an emerging technique designed to reduce carbon dioxide (CO2) levels in venous blood while enabling lung-protective ventilation or alleviating the work of breathing...

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High-risk pulmonary embolism: thesignificance and perspectives of pulmonaryreperfusion

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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Case Report: Oxygenator Burst During Minimally Invasive Coronary Artery Bypass Grafting (CABG) – A Critical Perfusion Incident

Abstract This case report discusses a rare and critical perfusion accident during a minimally invasive coronary artery bypass grafting (CAGB) procedure, where a Eurosets Skipper oxygenator burst 3 minutes after..

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ECMO Transport: Moving Critically Ill Patients Safely

Introduction Extracorporeal Membrane Oxygenation (ECMO) is a life-saving intervention for patients with severe cardiac and respiratory failure. However, the need for specialized ECMO care often necessitates the transport of critically..

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ECMO for Refractory Cardiogenic Shock: When Is It the Right Choice?

Introduction Refractory cardiogenic shock (RCS) is a life-threatening condition where the heart fails to supply adequate blood flow to the body's organs, despite maximal medical therapy. It is a major..

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Continuous Kidney Replacement Therapies: Core Curriculum 2025

Abstract Critically ill patients that require kidney replacement therapy (KRT) are among the most ill and complex patients routinely encountered in the intensive care unit (ICU). Continuous KRT (CKRT) is..

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Artificial Intelligence in Perfusion: The Future of Data-Driven Decision-Making

Introduction Artificial Intelligence (AI) is rapidly transforming perfusion, particularly in cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO). By leveraging machine learning (ML) and real-time data analysis, AI enhances decision-making,..

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ECMO in Cardiac Surgery: When and How to Implement It

Introduction Extracorporeal Membrane Oxygenation (ECMO) has become a vital intervention in cardiac surgery, offering temporary mechanical support for patients experiencing severe cardiac dysfunction. It stabilizes hemodynamics, allowing time for myocardial..

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A clinical comparison of the effects of six disposable cardiopulmonary bypass circuits on bleeding and coagulation: a quality assurance project

Abstract Purpose Cardiac surgery requiring cardiopulmonary bypass (CPB) is frequently complicated by excessive bleeding because of coagulopathy. Contact of blood with the CPB circuit is a major contributor. While several..

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Monitoring Hemostatic Function during Cardiac Surgery with Point-of-Care Viscoelastic Assays: A Narrative Review

Abstract Bleeding is a well-known and severe complication of cardiac surgery. Cardiopulmonary bypass, along with heparinization and hemodilution, is thought to affect all pathways of the hemostatic process, leading to..

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Advances in CPB Circuit Coatings: Impact on Biocompatibility and Inflammatory Response

Introduction Cardiopulmonary bypass (CPB) is a lifesaving technology in cardiac surgery, but it introduces blood-material interactions that trigger inflammatory and coagulative responses. To address these issues, advancements in biocompatible CPB..

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