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Modified Ultrafiltration Should Not Be Routinely Used in Adult Cardiac Surgery

Abstract Pediatric Literature As the practice of ultrafiltration arose from pediatric cardiac surgery, much of the evidence to support MUF is from low-powered pediatric studies. Some early, single-center literature, as..

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Modified Ultrafiltration Is Beneficial for Adults Undergoing Cardiac Surgery

Abstract Hemodilution and Volume Overload The use of CPB necessitates priming of the CPB circuit, which is typically accomplished using 1-to-2 liters of a crystalloid solution. In addition, 1-to-3 liters..

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Cytosorb Adsorption During Emergency Cardiac Operations in Patients at High Risk of Bleeding

Abstract Background The purpose of this study was to analyze the results of Cytosorb (CytoSorbents, Monmouth Junction, NJ) adsorption during emergency open heart operations in patients at high risk of..

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Neuromonitoring detects brain injury in patients receiving extracorporeal membrane oxygenation support

Abstract Objective There is limited evidence on standardized protocols for optimal neurological monitoring methods  receiving  (ECMO). We previously introduced protocolized noninvasive multimodal neuromonitoring using serial , electroencephalography,  ultrasound, and . The purpose of this study..

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Sodium citrate effectively used in shed mediastinal blood autotransfusion after cardiac surgery

Abstract Background We used sodium citrate as an alternative anticoagulation agent to heparin in the procedure of autologous blood transfusion with patients with postoperative haemorrhage after CPB. The aim of..

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Evaluation of Latex Immunoturbidimetric Assay Thresholds and HIT in Cardiothoracic Surgery

Abstract Background Heparin-induced thrombocytopenia (HIT) is a common differential diagnosis in cardiothoracic surgery. The latex immunoturbidimetric assay (LIA) is an enhanced immunoassay that has recently been introduced for the detection..

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In vitro study on the effect of fibrinogen γ-chain peptide-coated ADP-encapsulated liposomes on postcardiopulmonary bypass coagulopathy using patient blood

Abstract Background Fibrinogen γ-chain peptide-coated, adenosine 5'-diphosphate (ADP)-encapsulated liposomes (H12-ADP-liposomes) are potent hemostatic adjuvants that promote platelet thrombi formation at bleeding sites. Although we have reported the efficacy of these..

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Resistance to unfractionated heparin in the ICU: evaluation and management options

Abstract Because of its rapid onset and offset of action, and its ability to be fully and rapidly reversed with protamine when anticoagulation control is needed, unfractionated heparin (UFH) remains..

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Targeting the Contact Pathway of Coagulation for the Prevention and Management of Medical Device-Associated Thrombosis

Abstract Hemorrhage remains a major complication of anticoagulants, with bleeding leading to serious and even life-threatening outcomes in rare settings. Currently available anticoagulants target either multiple coagulation factors or specifically..

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The effects of differing anticoagulant regimes on blood quality after cell salvage in coronary artery bypass grafting (CABG): a pilot…

Abstract Background Cell salvage reduces allogenic blood transfusion requirements in surgery. We present a pilot study exploring the impact of anticoagulant choice, citrate or heparin, on the quality of cell..

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Comparison of anticoagulation monitoring strategies for adults supported on extracorporeal membrane oxygenation: A systematic review

Abstract Background Anticoagulation is critical in patients supported on extracorporeal membrane oxygenation (ECMO). The appropriate monitoring strategies for heparin remain unclear. Objectives This systematic review aimed to compare the accuracy..

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Bacteria in Extracorporeal Membrane Oxygenation Circuit Clots of a Patient With Persistent Bacteremia: A Case Report

Abstract A neonate with pulmonary hypertension was supported with extracorporeal membrane oxygenation (ECMO). During ECMO support, the patient developed Enterococcus faecalis bacteremia, treated with targeted antibiotics. Despite the maximum dose of antibiotics, routine blood..

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Coagulation support during perioperative bleeding management

Abstract Bleeding is a leading cause of perioperative mortality []. In a perioperative setting, damage control surgery with massive transfusion protocols (MTPs) are therapeutic approaches used clinically to manage patients..

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Anticoagulant biomimetic consecutive gas exchange network for advanced artificial lung membrane

Abstract Artificial lung membrane as extracorporeal blood-gas barriers could execute similar functions as human alveoli, whereby accomplish blood gas exchange process, providing imperative life support for patients with cardiopulmonary failure...

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Partial Heart Transplantation in Adult Cardiac Surgery

Abstract Many young adults require heart valve replacements. Current options for valve replacement in adults include mechanical valves, bioprosthetic valves, or the Ross procedure. Of these, mechanical and bioprosthetic valves..

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Coagulation Tests and Bleeding Classification After Cardiopulmonary Bypass: A Prospective Study

Abstract Objective No recent prospective studies have analyzed the accuracy of standard coagulation tests and thromboelastography (TEG) to identify patients with excessive microvascular bleeding following cardiopulmonary bypass (CPB). The aim..

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Perioperative Considerations in Management of the Severely Bleeding Coagulopathic Patient

Abstract Inherited and acquired coagulopathy are frequently associated with major bleeding in severe trauma, cardiac surgery with cardiopulmonary bypass, and postpartum hemorrhage. Perioperative management is multifactorial and includes preoperative optimization..

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The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

Abstract The aim of this experimantal study which is applied on rats, is to determine the differences on the clotting factors over the application of low and high intraabdominal pressure..

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Are Viscoelastic Tests Clinically Useful to Identify Platelet-Dependent Bleeding in High-Risk Cardiac Surgery Patients?

Abstract BACKGROUND:  Postoperative use of platelet function testing to rule out microvascular bleeding due to platelet dysfunction after cardiac surgery still lacks strong reference data and reliable cutoff values, yielding..

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Heparin Rebound: An In-Depth Review

Abstract The common conception of “heparin rebound” invokes heparin returning to circulation in the  after apparently adequate intraoperative reversal with . This is believed to portend increased  and provides the rationale for administering..

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A comparison of the ClotPro system with rotational thromboelastometry in cardiac surgery: a prospective observational study

Abstract Viscoelastic coagulation tests have been increasingly used for hemostasis management in cardiac surgery. The ClotPro system is a novel viscoelastic device based on principles of rotational thromboelastometry. We aimed..

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Does a balanced colloid decrease perioperative blood loss in paediatric cardiac surgery

Abstract BACKGROUND  Unbalanced fluid solutions cause metabolic acidosis and could be associated with impaired coagulation and increased blood loss. OBJECTIVE  To investigate whether the use of a balanced colloid compared..

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A novel poly (4-methyl-1-pentene)/polypropylene (PMP/PP) thin film composite (TFC) artificial lung membrane for enhanced gas transport and excellent hemo-compatibility

Abstract Extracorporeal membrane  is a technique that provides short-term supports to the heart and lungs. It removes CO2 from the blood and provides enough oxygen, which is a huge help in the..

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Haematological Trends and Transfusion during Adult Extracorporeal Membrane Oxygenation: A Single Centre Study

Abstract The temporal trends in haematological parameters and their associations with blood product transfusion requirements in patients supported with extracorporeal membrane oxygenation (ECMO) are poorly understood. We performed a retrospective..

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Risk factors for elective and emergency oxygenator exchanges during veno-venous extracorporeal membrane oxygenation

Abstract Background Despite systemic anticoagulation and antithrombotic surface coating, oxygenator dysfunction remains one of most common technical complications of Extracorporeal membrane oxygenation (ECMO). Several parameters have been associated with an..

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Surgical pulmonary embolectomy on VA-ECMO

Abstract Surgical pulmonary embolectomy is a procedure that is often used to rescue patients with massive pulmonary embolism (PE) and circulatory collapse that have failed or may not be ideal..

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Clues of incomplete reversal of heparin in cardiac surgery

Abstract Objectives In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these..

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Long-term ECMO, efficiency and performance of EUROSETS adult A.L.ONE ECMO oxygenator

Abstract Background The management of the oxygenator can be prolonged in the long-term procedures especially during extracorporeal membrane oxygenation (ECMO) for bridge to transplant or bridge to recovery. Long-term use..

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Antithrombin Replacement and Extracorporeal Membrane Oxygenation: The time is ripe for a Simpler Solution

Abstract The use of extracorporeal membrane oxygenation (ECMO) circuit obligates the administration of systemic anticoagulation to avoid patient and circuit thrombosis. Identifying an optimal approach for achievement of target pharmacologic..

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The pressure field as a methodology for fluid management and red cell preservation during cardiac surgery

Abstract Purpose Anemia and red cell transfusion contribute to morbidity and mortality of surgery. The concept of patient blood management to mitigate preoperative anemia, optimize coagulation, conserve red cells intraoperatively..

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