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The Role of Veno-Arterial Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism: A Case Report

Abstract Introduction: Amniotic fluid embolism (AFE) is a catastrophic complication of pregnancy with high mortality rate. It is an inflammatory response leading to cardiovascular collapse. We present a case of successful..

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2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP

Abstract Cardiac surgery is a distinctive surgical discipline that often necessitates the use of cardiopulmonary bypass (CPB) and full anticoagulation intraoperatively, along with varying levels of antithrombotic treatments both before..

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Evaluation of Point-of-Care-Directed Coagulation Management in Pediatric Cardiac Surgery

Abstract Background Coagulatory alterations are common after pediatric cardiac surgery and can be addressed with point-of-care (POC) coagulation analysis. The aim of the present study is to evaluate a preventive..

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In vitro protamine addition for coagulation assessment using TEG 6s system during cardiopulmonary bypass: a pilot study

Abstract Objective Systemic heparinization during cardiopulmonary bypass (CPB) can significantly affect thromboelastography (TEG). This study investigated the feasibility of adding protamine in vitro to allow assessment of coagulation status using the..

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Evaluating the Use of Unfractionated Heparin with Intra-Aortic Balloon Counterpulsation

Abstract Background Evidence supporting  with unfractionated heparin (UFH) in patients with an intra-aortic balloon pump (IABP) to prevent  remains limited, while bleeding risks remain high. Monitoring heparin in this setting with anti-factor..

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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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Temporal changes in markers of coagulation and fibrinolysis in adults during extracorporeal membrane oxygenation

Abstract Introduction Bleeding and thrombotic events (BTE) are frequent during extracorporeal membrane oxygenation (ECMO). They occur at varying timepoints and may be affected by temporal changes in coagulation and fibrinolysis...

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Impact of C-reactive Protein on Anticoagulation Monitoring in Extracorporeal Membrane Oxygenation

Abstract Objective To evaluate the impact of inflammation on  monitoring for patients supported with  (ECMO). Design Prospective single-center . Setting University-affiliated tertiary care academic medical center. Participants Adult venovenous and venoarterial ECMO patients..

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Progress towards permanent respiratory support

Abstract Purpose of review  Although lung transplantation stands as the gold standard curative therapy option for end-stage lung disease, the scarcity of available organs poses a significant challenge in meeting..

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Comprehensive Characterization of Surface-Bound Proteins and Measurement of Fibrin Fiber Thickness on Extracorporeal Membrane Oxygenation Circuits Collected From Patients

Abstract Objective:  To characterize surface-bound proteins and to measure the thickness of fibrin fibers bound to extracorporeal membrane oxygenation (ECMO) circuits used in children. Design:  Single-center observational prospective study, April..

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Rethinking Coagulation Activation during Extracorporeal Membrane Oxygenation: Insights from the Case of Mr. Hageman

Abstract Blood surface interfacing that occurs within the extracorporeal membrane oxygenation (ECMO) circuit initiates contact activation, an important hemostatic pathway initiated by the Hageman factor, also called factor XII. Factor..

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First 24-Hour-Long Intensive Care Unit Testing of a Clinical-Scale Microfluidic Oxygenator in Swine: A Safety and Feasibility Study

Abstract Microfluidic membrane oxygenators are designed to mimic branching vasculature of the native lung during extracorporeal lung support. To date, scaling of such devices to achieve clinically relevant blood flow..

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Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study

Abstract Introduction Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation..

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Role of Extracorporeal Membrane Oxygenation in the Treatment of Massive Pulmonary Embolism

Abstract Massive/high-risk pulmonary embolism (PE) is associated with a 30-day mortality rate of approximately 65%. In searching for strategies that may make a dent on this dismal mortality rate, investigators..

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Antithrombin restriction in extracorporeal membrane oxygenation support (ARES): A multidisciplinary approach

Abstract Background:   Antithrombin (AT) replacement is occasionally utilized in the setting of extracorporeal membrane oxygenation (ECMO)-associated heparin resistance. Although past studies emphasized the high costs and limited clinical benefit..

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Anti-Xa-guided Anticoagulation With Unfractionated Heparin and Thrombosis During Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-analysis

Abstract Objective The initiation of extracorporeal membrane oxygenation (ECMO) triggers complex coagulation processes necessitating systemic anticoagulation. Therefore, anticoagulation monitoring is crucial to avoid adverse events such as thrombosis and hemorrhage...

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Heparin-Induced Thrombocytopenia (HIT) in the Direct Oral Anticoagulants (DOAC) Era

Abstract Background Heparin-induced thrombocytopenia (HIT) is an uncommon complication of heparin therapy with significant risk for severe morbidity and mortality. We investigated the role and outcome of direct oral anticoagulants..

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Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

Abstract Patient blood management (PBM) guidelines for patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) have increased during the past decade, and pharmacotherapy plays an important role in PBM. In..

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Anticoagulation Strategies during Extracorporeal Membrane Oxygenation: A Narrative Review

Abstract The development of extracorporeal life support technology has added a new dimension to the care of critically ill patients who fail conventional treatment options. Extracorporeal membrane oxygenation (ECMO)—specialized temporary..

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Biomarkers of inflammation and coagulation after minimally invasive mitral valve surgery: a prospective comparison to conventional surgery

Abstract Objectives Minimally invasive cardiac surgery techniques are increasingly used but have longer cardiopulmonary bypass time, which may increase inflammatory response and negatively affect coagulation. Our aim was to compare..

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A novel technique employing specialized pumps for controlling selective cerebral and lower-body perfusion during cardiopulmonary bypass in aortic dissection surgery

Abstract To the Editor, After more than a decade of focused research, significant advancements have been made in the technology of cardiopulmonary bypass perfusion (CPB) for Type A aortic dissection (TAAD). Notably, there has been..

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Cannula-Associated Deep Vein Thrombosis Following Extracorporeal Membrane Oxygenation Decannulation: Incidence and Risk Factors

Abstract Thrombotic complications during and after extracorporeal membrane oxygenation (ECMO) are commonly observed clinically. The incidences of cannula-associated deep vein thrombosis (CaDVT) post-ECMO support have predominantly focused on Caucasian demographics...

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Activated clotting time value as an independent predictor of postoperative bleeding and transfusion

Abstract OBJECTIVES Activated clotting time (ACT) is commonly used to monitor anticoagulation during cardiac surgeries. Final ACT values may be essential to predict postoperative bleeding and transfusions, although ideal values..

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Anticoagulation Management in V-V ECMO Patients: A Multidisciplinary Pragmatic Protocol

Abstract Background: Extracorporeal membrane oxygenation (ECMO) is a complex procedure affecting both the risk of thrombosis and bleeding. High-quality data to personalize anticoagulation management in ECMO are lacking, resulting in..

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Mechanical-Enhanced and Durable Zwitterionic Hydrogel Coating for Inhibiting Coagulation and Reducing Bacterial Infection

Abstract Blood-contact medical devices are indispensable for clinical interventions, yet their susceptibility to thrombosis and bacterial infections poses substantial risks to treatment efficacy and patient well-being. This study introduces a..

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Whole blood storage duration alters fibrinogen levels and thrombin formation

Abstract INTRODUCTION  Whole blood resuscitation for hemorrhagic shock in trauma represents an opportunity to correct coagulopathy in trauma while also supplying red blood cells. The production of microvesicles in stored..

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Evaluation of the Nautilus Smart Extracorporeal Membrane Oxygenation in Patients With Hemostatic Alteration: A Case Series

Abstract The intricate management of hemostatic disorders in extracorporeal membrane oxygenation (ECMO) assisted patients poses challenges, particularly when procoagulant administration is necessary. We hereby report the performance of the Nautilus*..

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Anticoagulation Can Be Held in Traumatically Injured Patients on Veno-Venous Extracorporeal Membrane Oxygenation Support

Abstract Traumatic injury is associated with several pulmonary complications, including pulmonary contusion, transfusion-related acute lung injury (TRALI), and the development of acute respiratory distress syndrome (ARDS). There is a lack..

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The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative (PEACE) Consensus Conference

Abstract OBJECTIVES:  To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation..

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Interaction of heparin and protamine in presence of overdosage: in vitro study

Abstract Background Heparin is used for anticoagulation during cardiopulmonary bypass. After weaning from bypass, protamine is administered to neutralize the effects of heparin and thus reestablish hemostasis. Rotational thrombelastometry has..

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