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Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin

Abstract Objectives We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO). Methods We performed a retrospective cohort study of..

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Bivalirudin for cardiopulmonary bypass in a patient with heparin allergy

Abstract Background Hypersensitivity reactions to heparin are uncommon conditions but pose a serious clinical problem for patients requiring cardiopulmonary bypass. Bivalirudin is a reversible direct thrombin inhibitor that can be..

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Anti-Xa assay monitoring improves the precision of anticoagulation in venovenous extracorporeal membrane oxygenation

Abstract Unfractionated heparin (UFH) is the most used anticoagulant in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO). Its therapeutic levels are monitored using activated partial thromboplastin time ratio (aPTTr) or..

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What’s fishy about protamine? Clinical use, adverse reactions, and potential alternatives

Abstract Protamine, a highly basic protein isolated from salmon sperm, is the only clinically available agent to reverse the anticoagulation of unfractionated heparin. Following intravenous administration, protamine binds to heparin..

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The Surface of a PMP Hollow Fiber Membrane Was Modified with a Diamond-like Carbon Film to Enhance the Blood Compatibility…

Abstract The contact between the blood and the surface of medical materials causes a series of rejection reactions. In this process, the plasma protein is adsorbed to the surface of..

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Heparin consumption and inflammatory response according to the coating of cardiopulmonary bypass circuits in cardiac surgery: A retrospective analysis

Abstract Introduction There are several types of surface treatments (coatings) aimed at improving the biocompatibility of cardiopulmonary bypass (CPB) circuit. Some coatings appear to require higher doses of heparin to..

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Tranexamic Acid for Bleeding Management in Adult Patients on Extracorporeal Membrane Oxygenation

Abstract This study described the outcomes of patients receiving topical, nebulized, endobronchial, or systemic tranexamic acid (TXA) for bleeding events while on extracorporeal membrane oxygenation (ECMO). We performed a single-center..

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Platelets and fibrinogen matter when bleeding on ECMO

Abstract We have read with interest the work by Helms et al., a single-center study with 30 patients (16 on veno-venous and 14 on veno-arterial extracorporeal membrane oxy-genation (ECMO)), with..

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Anticoagulation and Bleeding during Veno-Venous Extracorporeal Membrane Oxygenation: Insights from the PROTECMO Study

Abstract Rationale: Definitive guidelines for anticoagulation management during veno-venous extracorporeal membrane oxygenation (VV ECMO) are lacking, while bleeding complications continue to pose major challenges. Objectives: To describe anticoagulation modalities and..

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Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study

Abstract Hemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB),..

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Reduced Invasiveness of Cardiopulmonary Bypass: The Mini-Circuit and the Micro-Cardioplegia

Abstract The aim of cardiopulmonary bypass is the maintenance of a sufficient whole body perfusion and gas exchange during open or closed heart surgery procedure (coronary artery bypass grafting, valve..

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Heparin-induced thrombocytopenia: An illustrated review

Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated  from unfractionated or low-molecular-weight heparin that results in thrombocytopenia and potentially catastrophic thrombosis. HIT occurs due to the development of platelet-activating antibodies against multimolecular..

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Prevalence of FXII-Deficiency and Its Relevance to Monitoring Anticoagulation in Adults Receiving Extracorporeal Membrane Oxygenation

Abstract During extracorporeal membrane oxygenation (ECMO) blood is exposed to artificial surfaces, resulting in contact activation of the intrinsic coagulation pathway initiated by coagulation factor XII (FXII). Little is known..

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Anticoagulation strategies in COVID-19 infected patients receiving ECMO support

Abstract Background: Hospitalized COVID-19 patients with hypoxemic respiratory failure may deteriorate despite invasive mechanical ventilation and thus require extracorporeal membrane oxygenation (ECMO) support. Unfractionated heparin (UFH) is the antithrombotic of..

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Protamine dose to neutralize heparin at the completion of cardiopulmonary bypass can be reduced significantly without affecting post-operative bleeding

Abstract Background: Systemic anticoagulation with heparin during cardiopulmonary bypass (CPB) should be neutralized by protamine administration to restore normal hemostasis. Our previous study showed the protamine-to-heparin ratio (P-to-H) of 1:1..

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Plasma-Free Strategy for Cardiac Surgery with Cardiopulmonary Bypass in Infants < 10 kg: A Retrospective, Propensity-Matched Study

Abstract Background: Infants < 10 kg undergoing cardiac surgery with cardiopulmonary bypass (CPB) may receive either fresh frozen plasma (FFP) or other solutions in the CPB priming volume. The existing..

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Advanced hemocompatible polyethersulfone composite artificial lung membrane with efficient CO2/O2 exchange channel constructed by modified carbon nanotubes network

Abstract Artificial lung membranes as the core module of the extracorporeal membrane oxygenation technology (ECMO) execute the function of extracorporeal blood-gas barrier accomplishing CO2/O2 exchange with blood. However, the unsatisfactory hemocompatibility..

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Association Between Thrombin–Antithrombin Complex and Acute Kidney Injury After Pediatric Cardiopulmonary Bypass Surgery: A Single-Center Retrospective Observational Study

Abstract Vascular endothelial damage may activate hypercoagulation and contribute to the development of acute kidney injury (AKI). This study aimed to investigate whether early alteration in coagulation was associated with..

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The impact of using fresh frozen plasma in cardiopulmonary bypass preparation on thromboelastometric parameters and receiving blood products among pediatric…

Abstract Introduction: The aim of this study was to determine the effect of fresh frozen plasma (FFP) for priming of cardiopulmonary bypass (CPB) circuit on rotational thromboelastometry (ROTEM) and transfusion in..

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Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

Abstract This literature review examines perfusion safety in cardiothoracic surgery, with a primary focus on cardiopulmonary bypass (CPB) and circulatory devices. PRISMA guidelines were followed and various databases, including PubMed,..

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Factor XII promotes the thromboinflammatory response in a rat model of venoarterial extracorporeal membrane oxygenation

Abstract Background  (FXII) is a multifunctional  capable of activating thrombotic and inflammatory pathways. FXII has been linked to thrombosis in  (ECMO), but the role of FXII in ECMO-induced inflammatory complications has not..

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Coagulation after paediatric miniaturised versus conventional cardiopulmonary bypass: Retrospective cohort study

Abstract Background Cardiopulmonary bypass (CPB) causes coagulation disorders after surgery. This study aimed to compare the coagulation parameters after congenital cardiac surgery with miniaturised CPB (MCPB) versus conventional CPB (CCPB)...

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Efficacy of autologous plateletpheresis in adult aortic surgery: study protocol for a randomised controlled trial

Abstract Introduction Perioperative coagulopathy is common in patients undergoing aortic surgery, increasing the risk of excessive blood loss and subsequent allogeneic transfusion. Blood conservation has become a vital part of cardiovascular..

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Activated Prothrombin Complex Concentrate in Pediatric Cardiac Patients, Our Early Experience

Abstract Background Pediatric cardiac surgery is associated with abnormal coagulation, bleeding, and nearly ubiquitous transfusions. With the popularization of patient blood management, attempts are being made to decrease liberal transfusions..

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Commercial and novel anticoagulant ECMO coatings: a review

Abstract Extracorporeal membrane oxygenation (ECMO) is an invasive and last-resort treatment for circulatory and respiratory failure. Prolonged ECMO support can disrupt the coagulation and anticoagulation systems in a patient, leading..

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Efficacy of Prostacyclin Anticoagulation in Critically Ill Patients Requiring Extracorporeal Support: A Systematic Review and Meta-Analysis

Abstract Extracorporeal support modalities are highly prothrombotic. Anticoagulation is frequently used for patients receiving Continuous Renal Replacement Therapy (CRRT), Molecular Adsorbent Recirculating System (MARS), and Extracorporeal Membrane Oxygenation (ECMO). The..

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The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass

Abstract Background Extracorporeal life support (ECLS) has extensive applications in managing patients with acute cardiac and pulmonary failure. Two primary modalities of ECLS, cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation..

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Bleeding patients on extracorporeal membrane oxygenation have reduced platelet aggregation and plasma fibrinogen: a longitudinal observational study

Abstract This study investigated changes in coagulation and associations with occurrence of bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy. The study included 100 adult ECMO-patients. Standard coagulation parameters,..

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Phosphorylcholine/Heparin Composite Coatings on Artificial Lung Membrane for Enhanced Hemo-compatibility

Abstract As the key component of extracorporeal membrane oxygenation (ECMO), artificial lung membranes have low gas permeability and plasma leakage problems, and the contact between membrane materials and blood can..

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Morbidity and Mortality Associated With Blood Transfusions in Elective Adult Cardiac Surgery

Abstract Objectives Perioperative transfusion thresholds have garnered increasing scrutiny as restrictive strategies have been shown to be noninferior. The study authors used data from a statewide academic collaborative to test..

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