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A Comparison of Separate Access versus In-Line Configuration for Continuous Renal Replacement Therapy in VV ECMO

Abstract Objective Continuous renal replacement therapy (CRRT) in patients receiving venovenous extracorporeal membrane oxygenation (VV ECMO) can be accessed via separate venous access (SVA) or directly “in-line” within the ECMO circuit...

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Coagulation and Transfusion Updates From 2021

Abstract 2021 and the COVID 19 pandemic have brought unprecedented blood shortages worldwide. These deficits have propelled national efforts to reduce blood usage, including limiting elective services and accelerating Patient..

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Perioperative Circulatory Support and Management for Lung Transplantation: A Case-Based Review

Abstract Lung transplantation (LTx) historically was performed with cardiopulmonary bypass (CPB) or Off-pump. Recent data suggest an increased interest in extracorporeal membrane oxygenation (ECMO) as perioperative circulatory support by many..

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Procoagulant platelets: novel players in thromboinflammation

Abstract Platelets play a key role in maintaining hemostasis. However, dysregulated platelet activation can lead to pathological thrombosis or bleeding. Once a platelet gets activated, it will either become an..

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Heparin Versus Bivalirudin for Anticoagulation in Adult Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

Abstract Extracorporeal membrane oxygenation (ECMO) poses unique thrombotic and hemorrhagic risks, and the optimal anticoagulant choice is unknown. We systematically searched Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and..

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Knowledge gaps and research priorities in adult veno‑arterial extracorporeal membrane oxygenation: a scoping review

Abstract Purpose: This scoping review aims to identify and describe knowledge gaps and research priorities in veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Methods: An expert panel was recruited consisting of eight..

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Tissue adhesive hemostatic microneedle arrays for rapid hemorrhage treatment

Abstract Blood loss by hemorrhaging wounds accounts for over one-third of ∼5 million trauma fatalities worldwide every year. If not controlled in a timely manner, exsanguination can take lives within..

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The Choice of Protamine Sulfate Dosing Regimen for Coronary Artery Bypass Graft Surgery

Abstract Changes in hemodynamics and coagulation hemostasis during the use of protamine sulfate to neutralize heparin in a ratio of 0.5:1 in coronary artery bypass graft surgery have been studied...

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Anticoagulation polyvinyl chloride extracorporeal circulation catheters for heparin-free treatment†

Abstract Extracorporeal circulation (ECC) catheters have potential to be blood compatible and could be used to prevent thrombotic occlusion. Here, we produced heparin-mimicking anticoagulation PVC tubing on a large scale..

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Heparin Resistance During Cardiopulmonary Bypass in Adult Cardiac Surgery

Abstract The use of heparin for anticoagulation has changed the face of cardiac surgery by allowing a bloodless and motionless surgical field throughout the introduction of cardiopulmonary bypass (CPB). However,..

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Citrate does not change viscoelastic haemostatic assays after cardiopulmonary bypass

Abstract Context: Viscoelastic hemostatic assays (VHA) are commonly used to identify specific cellular and humoral causes for bleeding in cardiac surgery patients. Cardiopulmonary bypass (CPB) alterations to coagulation are observable on..

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Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation

Abstract The effect and safety of bivalirudin compared with heparin in patients undergoing extracorporeal membrane oxygenation (ECMO) remains unclear. Therefore, we conducted a systematic review and meta-analysis to compare the effectiveness and..

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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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A Novel Anticoagulation Method Based on Electrochemical Characteristics of Blood: An in vitro Study

Abstract This in vitro experimental investigation aimed to provide a novel method for preventing blood clotting based on the electrochemical characteristics of blood. Using this method in cases such as..

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Hemostatic alterations during extracorporeal membrane oxygenation in ovine veno-venous and veno-arterial models

Abstract Background Extracorporeal membrane oxygenation (ECMO) has salvaged many people's life during global pandemics. However, ECMO is associated with a high incidence of hemostatic complications. This study aims to explore..

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Perioperative Management of a Patient With Combined Bernard Soulier syndrome and Storage Pool Disease During On-Pump Cardiac Surgery

Abstract Bernard Soulier syndrome is a rare hereditary macrothrombocytopenia, with an incidence of <1 per million.  Patients may have variable platelet counts, ranging from <10 × 109/L to normal, as well as..

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Use of CytoSorb in a patient with acute bleeding complications due to oral anticoagulation with rivaroxaban

This report describes the case of a 68-year-old patient (known medical history: untreated chronic obstructive pulmonary disease (COPD), ectopic atrial tachycardia, liver cirrhosis CHILD stage B, no contact with physicians..

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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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