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Platelet preservation in cardiac surgery using minimally invasive extracorporeal circulation versus optimized cardiopulmonary bypass

Abstract Background Minimally invasive extracorporeal circulation (MiECC) is employed as a strategy to attenuate the physiologic disturbance caused by cardiopulmonary bypass. The aim of this study was to compare the..

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HeartMate left ventricular assist device for long-term circulatory support

Abstract We describe three successful cases of HeartMate left ventricular assist device (LVAD; Thermo Cardiosystems, Woburn, MA, USA) implantation in patients with end-stage heart failure for long-term circulatory support. Patient..

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Investigation of heparin-loaded poly(ethylene glycol)-based hydrogels as anti-thrombogenic surface coatings for extracorporeal membrane oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO), a critical life-sustaining tool, faces significant challenges for the maintenance of normal haemostasis due to the large volume of circulating blood continuously in contact with..

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Use of nafamostat mesilate for anticoagulation during extracorporeal membrane oxygenation: A systematic review

Abstract Background Extracorporeal membrane oxygenation (ECMO) represents an advanced option for supporting refractory respiratory and/or cardiac failure. Systemic anticoagulation with unfractionated heparin (UFH) is routinely used. However, patients with bleeding..

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Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Abstract Despite the many advances in cardiovascular medicine, decisions concerning the diagnosis, prevention, and treatment of left ventricular (LV) thrombus often remain challenging. There are only limited organizational guideline recommendations..

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Delivering optimal renal replacement therapy to critically ill patients with acute kidney injury

Abstract Critical illness is often complicated by acute kidney injury (AKI). In patients with severe AKI, renal replacement therapy (RRT) is deployed to address metabolic dysfunction and volume excess until..

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The relationship between antithrombin administration and inflammation during veno-venous ECMO

Abstract Veno-venous Extracorporeal Membrane Oxygenation (ECMO) is used in the most severe cases of respiratory failure and further exacerbates the patients’ inflammatory status. Antithrombin is supplemented during ECMO for its..

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In vitro comparison of spatiotemporal fibrin clot formation dynamics in plasma treated with different protamine-heparin ratios

Abstract Introduction Our study aim was to explore how different protamine-heparin ratios impacted enzymatic coagulation and acellular fibrin clot growth in plasma using an in vitro model. We hypothesized that..

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Accuracy of point-of-care coagulation testing during cardiopulmonary bypass in a patient post COVID-19 infection

Abstract Introduction Extracorporeal circulation (ECC) in cardiac surgery is performed under systemic heparinization. Adequacy of heparin therapy and anticoagulation during ECC is assessed by activated clotting time (ACT), although there..

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Development and Blood Compatibility of a Stable and Bioactive Metal–Organic Framework Composite Coating for Blood-Circulation Tubing

Abstract Medical devices that require substantial contact between blood and a foreign surface would be dramatically safer if constructed from materials that prevent clot formation and coagulation disturbance at the..

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Thrombus formation during ECMO: Insights from a detailed histological analysis of thrombus composition

Abstract Objectives Intra-device thrombosis remains one of the most common complications during extracorporeal membrane oxygenation (ECMO). Despite anticoagulation, approximately 35% of patients develop thrombi in the membrane oxygenator, pump heads,..

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Titrated versus conventional anticoagulation management for thrombin generation in cardiac surgery: a randomized controlled trial

Abstract Purpose Optimal heparin titration during cardiopulmonary bypass (CPB) may reduce coagulation system activation and preserve hemostatic function post-CPB. Our objective was to assess if the Heparin Management System (HMS)..

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Perioperative Management of Bleeding and Transfusion for Lung Transplantation

Abstract Perioperative allogeneic blood product transfusion is common in lung transplantation and has various implications on the short- and long-term outcomes of lung recipients. This review summarizes the effect of..

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Impact of cardiopulmonary bypass duration on efficacy of fibrinogen replacement with cryoprecipitate compared with fibrinogen concentrate: a post hoc analysis…

Abstract Background Coagulopathy in cardiac surgery is frequently associated with acquired hypofibrinogenaemia, which can be treated with either purified fibrinogen concentrate (FC) or cryoprecipitate. Because the latter is not purified..

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Recent advancements in pediatric cardiopulmonary bypass technology for better outcomes of pediatric cardiac surgery

Abstract Background Pediatric cardiac surgery is in itself very enigmatic and individualized. Presently, there has been a slew of new developments aimed primarily toward pediatric cardiopulmonary bypass for safer, patient-centered..

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Mitral Valve Dysfunction in Patients With Annular Calcification

Abstract Various anticoagulant properties have been associated with hydroxyethyl starch (HES). However, the mechanism remains unclear and it has not been fully considered whether these properties are beyond the dilutional..

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Rotational Thromboelastometry Values After On-Pump Cardiac Surgery – A Retrospective Cohort Study

Abstract Background Viscoelastic coagulation monitoring is recommended for coagulation management after cardiac surgery, but optimum target values are poorly defined. Aims To determine “to-be-expected” values in rotational thromboelastometry (ROTEM) after..

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Hypothermic circulatory arrest does not induce coagulopathy in vitro

Abstract Hypothermic circulatory arrest (HCA) is an essential procedure during aortic surgery to protect organs; however, hypothermia is believed to cause coagulopathy, which is a major fatal complication. This study..

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Activated Clotting Times Demonstrate Weak Correlation With Heparin Dosing in Adult Extracorporeal Membrane Oxygenation

Abstract Background:  The optimal monitoring strategy for anticoagulation management in extracorporeal membrane oxygenation (ECMO) remains a clinical controversy. The Extracorporeal Life Support Organization Anticoagulation Guidelines suggest that multiple anticoagulation assays..

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Biological Response to Sintered Titanium in Left Ventricular Assist Devices: Pseudoneointima, Neointima, and Pannus

Abstract Titanium alloys have traditionally been used in blood-contacting cardiovascular devices, including left ventricular assist devices (LVADs). However, titanium surfaces are susceptible to adverse coagulation, leading to thrombogenesis and stroke...

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A Case Report of Severe Factor XI Deficiency during Cardiac Surgery: Less Can Be More

Abstract Severe congenital Factor XI (FXI) deficiency (<20% normal activity) can be associated with significant bleeding disorders, and there has been great concern for severe bleeding following cardiac surgery requiring..

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Effect of intraoperative cell rescue on bleeding related indexes after cesarean section Yu YF, Cao YD. Effect of intraoperative cell rescue…

Abstract Obstetric hemorrhage is the leading cause of maternal mortality globally, especially in China. The key to a successful rescue is immediate and rapid blood transfusion. Autotransfusion has become an..

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Anticoagulation on Extracorporeal Support: An Alternative Strategy

Abstract This approach is based on subcutaneous administration of low-molecular-weight heparin (LMWH) 3 times a day, paired with antifactor Xa (anti-Xa) assay monitoring, 3 times a day, each sample equidistant..

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An unanticipated prolonged baseline ACT during cardiac surgery due to factor XII deficiency

Abstract Factor XII (FXII) deficiency is a congenital disorder inherited as an autosomal recessive condition. In his heterozygous form, it is relatively common in the general population. However, a total..

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Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting

Abstract Objectives Extracorporeal membrane oxygenation (ECMO) involves complex coagulation management and frequent hemostatic complications. ECMO practice between centers is variable. To compare results between coagulation studies, standardized definitions and clear..

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Hemorrhagic complications in Veno-Venous Extracorporeal life Support—Development and internal validation of multivariable prediction model in adult patients

Abstract Background During extracorporeal life support (ECLS), bleeding is one of the most frequent complications, associated with high morbidity and increased mortality, despite continuous improvements in devices and patient care...

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Biomaterials as Haemostatic Agents in Cardiovascular Surgery: Review of Current Situation and Future Trends

Abstract Intraoperative haemostasis is of paramount importance in the practice of cardiovascular surgery. Over the past 70 years, topical haemostatic methods have advanced significantly and today we deal with various..

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The Pathophysiology of The Antiphospholipid Syndrome: A Perspective From The Blood Coagulation System

Abstract The antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by a hypercoagulability associated to vascular thrombosis and/or obstetric morbidity, is caused by the presence of antiphospholipid antibodies such as..

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Comparison of coagulation monitoring using ROTEM and Sonoclot devices in cardiac surgery. A single-centre prospective observational study

Abstract BACKGROUND: Viscoelastic tests (VETs) are recommended during cardiac surgery to monitor coagulation status and guide transfusion. We compared the results of two VETs, the Sonoclot Analyzer and the ROTEM..

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Sonoclot’s usefulness in prediction of cardiopulmonary arrest prognosis: A proof of concept study

Abstract The aim of the present study was to evaluate the usefulness of measuring whole blood coagulation with Sonoclot to predict return of spontaneous circulation (ROSC) in patients with out-of-hospital..

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