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Anticoagulation in Extracorporeal Membrane Oxygenation for Trauma: Striking a Balance

Abstract Extracorporeal membrane oxygenation in a venovenous configuration (VV-ECMO) is increasingly recognized as an important therapeutic option for patients with severe acute respiratory distress syndrome (ARDS). Accumulating scientific evidence as well..

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Platelet-sparing properties of aprotinin

Abstract BACKGROUND  Cardiac surgery involving cardiopulmonary bypass (CPB) is associated with the risk of acquired coagulopathy, including dysregulated fibrinolysis, which can result in life-threatening bleeding complications. Aprotinin, an antifibrinolytic agent,..

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A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood

Abstract The currently available point-of-care hemostasis tests are burdened by criticisms concerning the use of different activators and inhibitors and the lack of dynamic flow. These operating conditions may constitute..

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Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation

Abstract Objectives:  To test feasibility of a randomized controlled trial (RCT) with an endpoint of time at goal anticoagulation in children on extracorporeal membrane oxygenation (ECMO) randomized to receive bivalirudin..

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Concurrent use of continuous kidney replacement therapy during extracorporeal membrane oxygenation: what pediatric nephrologists need to know—PCRRT-ICONIC practice points

Abstract Extracorporeal membrane oxygenation (ECMO) provides temporary cardiorespiratory support for neonatal, pediatric, and adult patients when traditional management has failed. This lifesaving therapy has intrinsic risks, including the development of..

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Between a rock and a hard place: anticoagulation management for ECMO

Abstract Anticoagulation is an essential component of optimal extracorporeal membrane oxygenation (ECMO) management. Unfractionated heparin is still the anticoagulant of choice in most centers due to longstanding familiarity with the..

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Non-intensive care unit feasibility for ambulatory veno-venous extracorporeal membrane oxygenation patients

Abstract Introduction Veno-venous extracorporeal membrane oxygenation has increasingly been utilized to support patients in respiratory failure as a bridge to recovery or lung transplantation. As patients progress from cannulation to..

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Unraveling the Blood Biomaterial Interaction During Extracorporeal Membrane Oxygenation

Abstract Pediatric extracorporeal membrane oxygenation (ECMO) provides lifesaving cardiopulmonary support for patients with a multitude of clinical diagnoses, resulting from cardiac and/or respiratory failure refractory to conventional supports (). The..

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Extracorporeal membrane oxygenation in severe traumatic brain injury: Is it safe?

Abstract BACKGROUND  Patients with severe traumatic brain injury (TBI) are at an increased risk of respiratory failure refractory to traditional therapies. The safety of extracorporeal membrane oxygenation (ECMO) in this..

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Evaluation of Red Blood Cell Biochemical Markers and Coagulation Profiles Following Cell Salvage in Cardiac Surgery: A Systematic Review and…

Abstract Background: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell..

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Urgent Reversal of Direct Oral Anticoagulants in Critical and Life-Threatening Bleeding: A Multidisciplinary Expert Consensus

Abstract Direct oral anticoagulants (DOACs) are increasingly being used due to their improved efficacy/safety ratio and lower clinical and economic burden when compared to vitamin K antagonists. However, bleeding is..

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Association Between Cerebral Microbleeds and Neurological Outcomes in Patients Who Underwent Extracorporeal Membrane Oxygenation

Abstract Background Cerebral microbleeds (CMBs) are common and varied in patients receiving extracorporeal membrane oxygenation (ECMO). Here, the authors describe CMB findings in patients receiving ECMO and their association with..

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Anaphylactic Reaction to Protamine Sulfate: A Case Report

Abstract Protamine sulfate is a standard agent used to reverse heparin anticoagulation during cardiovascular procedures such as coronary artery bypass grafting (CABG). Although rare, it can be associated with severe..

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Association of Activated Clotting Time–Guided Anticoagulation with Complications during Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-Analysis

Abstract Objective Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to reduce the risk of thromboembolic events. Despite its historic role, activated clotting time (ACT) remains a widely used heparin monitoring..

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Cardiopulmonary bypass in a pediatric patient with factor XII deficiency

Abstract The safe use of cardiopulmonary bypass (CPB) relies upon the ability to administer, monitor, and reverse anticoagulation. Although rare, the factor XII deficient patient creates a challenge for the..

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Bivalirudin in Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is a mechanical support treatment modality used in patients with refractory cardiac and/or pulmonary failure. Bleeding and thrombotic complications associated with ECMO are inherent concerns..

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Protamine Dosing for Heparin Reversal after Cardiopulmonary Bypass: A Double-blinded Prospective Randomized Control Trial Comparing Two Strategies

Abstract Background Drug shortages are a frequent challenge in current clinical practice. Certain drugs (e.g., protamine) lack alternatives, and inadequate supplies can limit access to services. Conventional protamine dosing uses..

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Thromboembolic Complications in Continuous Versus Interrupted Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation: A Multicenter Study

Abstract OBJECTIVES:  Continuous, therapeutic anticoagulation is the standard of care for patients on extracorporeal membrane oxygenation (ECMO). The risks of hemorrhage exacerbated by anticoagulation must be weighed with the thrombotic..

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International Clinical Practice Guideline Recommendations for Acute Pulmonary Embolism: Harmony, Dissonance, and Silence

Abstract Despite abundant clinical innovation and burgeoning scientific investigation, pulmonary embolism (PE) has continued to pose a diagnostic and management challenge worldwide. Aging populations, patients living with a mounting number..

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Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

Abstract OBJECTIVES:  To identify and prioritize research questions for anticoagulation and hemostasis management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE)..

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Anticoagulant Medications: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

Abstract OBJECTIVES:  To derive systematic-review informed, modified Delphi consensus regarding the medications used for anticoagulation for pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE (PEACE). DATA SOURCES: ..

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Assessing Venous Thrombotic Risks in Extracorporeal Membrane Oxygenation-Supported Patients: A Systematic Review and Meta-Analysis

Abstract This study investigates the prevalence and risk factors associated with venous thrombotic events in patients receiving (ECMO) support. Systematic review and meta-analysis of case-control and cohort studies. PubMed, Cochrane..

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Low Versus Standard Intensity Heparin Protocols in Adults Maintained on Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study

Abstract Background:  Patients maintained on extracorporeal membrane oxygenation (ECMO) often require systemic anticoagulation to prevent circuit clotting and systemic thromboembolic complications. The optimal intensity of anticoagulation to balance the risk..

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Cardiopulmonary bypass and VA-ECMO induced immune dysfunction: common features and differences, a narrative review

Abstract Cardiopulmonary bypass (CPB) and veno-arterial extracorporeal membrane oxygenation are critical tools in contemporary cardiac surgery and intensive care, respectively. While these techniques share similar components, their application contexts differ,..

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Is it useful to wash stored red blood cells in cardiopulmonary bypass priming fluid for neonatal cardiac surgery? A single-centre…

Abstract Background and Objectives Neonatal cardiac surgery requires careful consideration of cardiopulmonary bypass (CPB) priming fluid composition due to small blood volume and immature physiology. This study investigated the impact..

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Unraveling the Blood Biomaterial Interaction During Extracorporeal Membrane Oxygenation

Abstract Pediatric extracorporeal membrane oxygenation (ECMO) provides lifesaving cardiopulmonary support for patients with a multitude of clinical diagnoses, resulting from cardiac and/or respiratory failure refractory to conventional supports. The utilization..

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A case of anaphylactic shock to human fibrinogen infusion during cardiac surgery

Abstract Human fibrinogen (FIB) has been clinically proven to be considerably effective for the treatment of postoperative bleeding, with reported cases of allergic reactions to human FIB being rare. Here,..

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A novel miniaturized roller pump circuit for simulation of extracorporeal circulation

Abstract OBJECTIVES Extracorporeal circulation induces pronounced effects on haemostasis and rheology. To study these, an ex vivo simulation model is an attractive alternative but often requires large amounts of blood. We sought..

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An endothelium membrane mimetic antithrombotic coating enables safer and longer extracorporeal membrane oxygenation application

Abstract Thrombosis and plasma leakage are two of the most frequent dysfunctions of polypropylene (PP) hollow fiber membrane (PPM) used in extracorporeal membrane oxygenation (ECMO) therapy. In this study, a..

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VA-ECMO as a support therapy in massive acute pulmonary embolism treated with catheter-directed thrombolysis

Abstract Introduction: Acute pulmonary embolism (PE) leads to increased pulmonary vascular resistance and right ventricular afterload, resulting in right ventricular dysfunction (RVD). Stratification is crucial to early identify patients with elevated..

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