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How to manage anticoagulation during extracorporeal membrane oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) use is increasing worldwide, driven by device simplification and increasing need during the coronavirus disease 2019 (COVID-19) pandemic, while bleeding and thrombotic events remain a..

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Outcomes with Direct and Indirect Thrombin Inhibition during Extracorporeal Membrane Oxygenation for COVID-19

Abstract Anticoagulation during extracorporeal membrane oxygenation (ECMO) for Coronovirus Disease 2019 (COVID-19) can be performed by direct or indirect thrombin inhibitors but differences in outcomes with these agents are uncertain...

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Pulmonary embolism response team: A multidisciplinary approach to pulmonary embolism treatment. Polish PERT Initiative Report

Abstract Background:A pulmonary embolism response team (PERT) is a multidisciplinary team established to improve clinical care for patients with pulmonary embolism (PE). However, data regarding detailed institutional experience and clinical..

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Injection of Recombinant Tissue Plasminogen Activator into Extracorporeal Membrane Oxygenators Postpones Oxygenator Exchange in COVID-19

Abstract Coronavirus disease 2019 (COVID-19) has drastically increased the number of patients requiring extracorporeal life support. We investigate the efficacy and safety of low-dose recombinant tissue-type plasminogen activator (rtPA) injection..

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Impact of Heparin- or Nonheparin-Coated Circuits on Platelet Function in Pediatric Cardiac Surgery

Abstract Background: Extracorporeal circuit coating has been shown to improve coagulation derangements during pediatric cardiopulmonary bypass (CPB). This study compared platelet function and hemostasis activation in pediatric cardiac surgery conducted with..

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Disseminated intravascular coagulation: epidemiology, biomarkers, and management

Abstract Disseminated intravascular coagulation (DIC) is a systemic activation of the coagulation system, which results in microvascular thrombosis and, simultaneously, potentially life-threatening haemorrhage attributed to consumption of platelets and coagulation..

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Infradiaphragmatic partial anomalous pulmonary venous connection in adulthood. Considerations for management: a single centre experience

Abstract Background and objectives: Infradiaphragmatic partial anomalous pulmonary venous connection is occasionally diagnosed in adulthood. Management of infradiaphragmatic PAPVC depends on anatomy and clinical presentation. Methods: Over a 10-year period, we observed..

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Hemostatic Management in Extracorporeal Membrane Oxygenation

Abstract The use of extracorporeal membrane oxygenation (ECMO) for acute cardiac and/or respiratory failure has grown exponentially in the past several decades. Systemic anticoagulation is a fundamental element of caring..

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Evaluation of the effects of three designs of oxygenators with integrated filters on clinical and haematological outcomes at an Australasian…

Abstract Introduction: Cardiopulmonary bypass (CPB) machines have oxygenators with integrated filters and unique biocompatible coatings to combat systemic inflammatory response syndrome (SIRS) and mitigate coagulopathy. Contemporary oxygenators have undergone comparative..

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Cardiac Surgery and Blood-Saving Techniques: An Update

Abstract Cardiac surgery is typically attributed with a significant risk of intraoperative blood loss and allogeneic blood transfusions. Intraoperative blood loss, allogenic blood transfusions, high dose anticoagulation requirement, and interactions..

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Prothrombin Complex Concentrates to Treat Coagulation Disturbances: An Overview With a Focus on Use in Infants and Children

Abstract Various factors may lead to coagulation disturbances following cardiopulmonary bypass and surgery for congenital heart disease. In addition to the risks associated with the administration of allogeneic blood products,..

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Is bivalirudin an alternative anticoagulant for extracorporeal membrane oxygenation (ECMO) patients? A systematic review and meta-analysis

Abstract Background Anticoagulation is important for extracorporeal membrane oxygenation (ECMO). Heparin is widely used; however, in some cases, it is not suitable for patients. Bivalirudin has been recently proposed for..

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Cerebral Oximetry-Monitored Nitroglycerin Infusion and Tissue Perfusion during Rewarming of Cardiopulmonary Bypass in Cardiac Surgery: A Prospective Randomized Trial

Abstract Background: Nitroglycerin facilitates microcirculation and oxygen delivery through vasodilation. The purpose of this study was to clarify the effects of nitroglycerin-induced vasodilation and potential hypotension on tissue perfusion under..

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Case Report of a Successful Pediatric Central Venovenous Extracorporeal life Support via Right Atrium-Pulmonary Artery Cannulation for Severe Chest Trauma…

Abstract Hypoxemic arrests due to severe traumatic pulmonary injury may not respond to usual medical support. Extracorporeal life support (ECLS) can be life-saving; adequate flows are needed in this setting..

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Platelet Dysfunction in Cardiac Surgery: When is the Best Time to Assess It? An Observational Single Center Study

Abstract Purpose. Cardiac surgery is characterized by a high risk of complications related to perioperative bleeding. Guidelines suggest the use of local algorithms based on perioperative point-of-care tests to assess and..

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Does the Volume and Constitution of Cardiopulmonary Bypass Priming Fluids Affect Blood Loss After Cardiac Surgery in Children?

Abstract Pediatric patients, especially neonates and infants, undergoing cardiac surgery, are at particularly high risk for developing surgical bleeding. After separation from cardiopulmonary bypass (CPB), excessive bleeding in children frequently..

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Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices

Abstract Viscoelastic hemostatic assay (VHAs) are whole blood point-of-care tests that have become an essential method for assaying hemostatic competence in liver transplantation, cardiac surgery, and most recently, trauma surgery..

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Blood Products, Crystalloids, and Rapid Infusion: An Experimental Study With Magnesium

Abstract Objectives Calcium and magnesium are concentration-dependent pro- and anticoagulant cofactors, and magnesium behaves similarly to calcium in the presence of citrate. The authors hypothesized that magnesium can cause clot..

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A Patient-Tailored Approach to Management of Acute Limb Ischemia in Patients with COVID-19: A Case Series

Abstract BACKGROUND: Coronavirus disease 2019 (COVID-19) has a tremendous impact on the respiratory tract. In severe COVID-19 infections, patients may experience shock and multiple organ failure. We described 4 cases of..

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A novel autotransfusion device saving erythrocytes and platelets used in a 72 h survival swine model of surgically induced controlled…

Abstract Background The purpose of this study was to develop a swine model of surgically induced blood loss to evaluate the performances of a new autotransfusion system allowing red blood..

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Extensive cell salvage and postoperative outcomes following thoracoabdominal and descending aortic repair

Abstract Objective Cell salvage (CS) reduces intraoperative . However, it may cause deformity of the red blood cells and loss of , which may lead to unwanted . Thus, we hypothesized that extensive..

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Optimizing Perioperative Blood and Coagulation Management During Cardiac Surgery

Abstract Major blood loss remains common in cardiac surgery with an incidence of up to 15%. Bleeding leads to anemia and blood product transfusion, and can lead to the need..

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A Randomized Pilot Trial Assessing the Role of Human Fibrinogen Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants…

Abstract The objective of this study was to determine whether treatment with human fibrinogen concentrate decreases the need for component blood therapy and blood loss in neonate and infant patients..

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MASTER OF SCIENCE IN CARDIOVASCULAR PERFUSION -Northern Kentucky Univ

WHAT YOU WILL LEARN A cardiovascular perfusionist is an essential member of the cardiac surgical team who specializes in operating extracorporeal circulation equipment to support the patient during an open-heart..

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Surgically Implanted Impella Device for Patients on Impella CP Support Experiencing Refractory Hemolysis

Abstract The Impella CP (Abiomed Inc., Danvers, MA) is widely used in cardiac catheterization laboratories for patients presenting with cardiogenic shock, but it is also known to cause significant hemolysis. The risk..

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Third-Generation Hydroxyethyl Starch Causes Dose-Dependent Coagulopathy in Patients Undergoing Off-Pump Coronary Artery Bypass with Continuation of Preoperative Aspirin

Abstract Background: We aimed to evaluate the effect of third-generation hydroxyethyl starch (6% HES 130/0.4) on hemostasis and perioperative blood loss in patients undergoing off-pump coronary artery bypass (OPCAB) with..

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Aptamer-based factor IXa inhibition preserves hemostasis and prevents thrombosis in a piglet model of ECMO

Abstract Extracorporeal membrane oxygenation (ECMO) requires anticoagulation to prevent clotting when the patient’s blood contacts the circuit. Unfractionated heparin (UFH) usually prevents clotting but can cause life-threatening bleeding. An anticoagulant..

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Emicizumab does not interfere with the activated clotting time

Abstract Introduction The activated clotting time (ACT) is a useful marker of unfractionated heparin (UFH) activity during cardiopulmonary bypass (CPB) or cardiac catheterization. Emicizumab, recently approved for bleeding prevention in..

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Clinical application of viscoelastic point-of-care tests of coagulation-shifting paradigms

Abstract Bleeding during cardiac surgery, liver transplant, trauma and post partum hemorrhage are often multifactorial and these factors are dynamic as new factors crop up during the course of management...

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It takes two to bleed: anticoagulation intensity and the host’s vascular susceptibility

Abstract We have read with interest the report of ELSO-registry data published by Nunez and coworkers in Intensive Care Medicine analyzing risk factors for bleeding and thrombotic events (BTE) on..

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