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Acute Kidney Injury and Extracorporeal Membrane Oxygenation: Review on Multiple Organ Support Options

Abstract Extracorporeal membrane oxygenation (ECMO) is a temporary life support system used to assist patients with life-threatening severe cardiac and/or respiratory insufficiency. Patients requiring ECMO can be considered the sickest..

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Comparison of the Effects of Ringer’s Lactate and 6% Hydroxyethyl Starch 130/0.4 on Blood Loss and Need for Blood Transfusion…

Abstract Background Infusion of crystalloids fluid replacement therapy tends to cause a greater expansion of intravascular volume. However, colloids can affect blood coagulation leading to greater blood loss and transfusion requirements. This..

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Which factors have a great impact on coagulopathy and hemostatic impairment after cardiopulmonary bypass in cardiovascular surgery? An analysis based…

Abstract Objectives This study aimed to investigate which factors have a great impact on coagulopathy after cardiopulmonary bypass (CPB) using rotational thromboelastometry (ROTEM). Methods Ninety-eight patients undergoing cardiovascular surgery using..

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Patient blood management and blood conservation – Complimentary concepts and solutions for blood establishments and clinical services in South Africa…

Abstract  come with risks and high costs, and should be utilized only when clinically indicated. Decisions to transfuse are however not always well informed, and lack of clinician knowledge and..

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Factor XI Inhibition to Uncouple Thrombosis From Hemostasis: JACC Review Topic of the Week

Abstract Hemostasis and thrombosis are believed to be so intricately linked that any strategies that reduce thrombosis will have an inevitable impact on hemostasis. Consequently, bleeding is viewed as an unavoidable..

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Virtual reality device training for extracorporeal membrane oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is a last resort therapy for patients with terminal respiratory failure. In the current worldwide surge of critically ill patients with novel coronavirus disease (COVID-19),..

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Priming solution for neonatal and pediatric cardiopulmonary bypass

Abstract The Priming volume of the oxygenators has been reduced by 75% during the last two decades and it is now possible to go safely on bypass with a priming..

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Synthetic Material Abdominal Swabs Reduce Activation of Platelets and Leukocytes Compared to Cotton Materials

Abstract During surgical procedures, cotton abdominal swabs with their high absorptive capacity and malleability are used to retain organs and absorb blood or other body fluids. Such properties of the..

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Month-long Respiratory Support by a Wearable Pumping Artificial Lung in an Ovine Model

Abstract Background.  A wearable artificial lung could improve lung transplantation outcomes by easing implementation of physical rehabilitation during long-term pretransplant respiratory support. The Modular Extracorporeal Lung Assist System (ModELAS) is..

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Role of Platelet Function Test in Predicting Postoperative Bleeding Risk after Coronary Artery Bypass Grafting: A Prospective Observational Study

Abstract Patients undergoing cardiac surgery are at risk of excessive bleeding and its associated complications. Excessive bleeding during and after cardiac surgery has an incidence of ~20%. Massive bleeding and..

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Rotational thromboelastometry and conventional coagulation tests in patients undergoing major cardiac or aortic surgery: a retrospective single-center cohort study

Abstract Algorithms for treatment of diffuse bleeding in cardiac surgery are based on intervention thresholds of coagulation tests, such as rotational thromboelastometry (ROTEM) or conventional laboratory tests. The relationship between..

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Haemostasis in Cardiac Surgery

Abstract The following sections are included: HISTORICAL NOTE DYNAMICS OF COAGULATION, FIBRINOLYSIS, AND COMPLEMENT ACTIVATION CARDIOPULMONARY BYPASS (CPB) Role of Oxygenators in Haemostasis   ANTI-COAGULATION DURING CARDIOPULMONARY BYPASS Heparin Protamine..

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Time course of risk factors associated with mortality of 1260 critically ill patients with COVID‑19 admitted to 24 Italian intensive…

Abstract Purpose: To evaluate the daily values and trends over time of relevant clinical, ventilatory and laboratory parameters during the intensive care unit (ICU) stay and their association with outcome..

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Heparin beyond anti-coagulation

Abstract Heparin has served as a mainstream  for over eight decades. Clinically heparin-derived compounds significantly contribute to prevention and treatment of thrombotic events complicated in numerous medical conditions such as ,  and  processes. Moreover..

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The role of hydrocortisone pre-treatment in decreasing side effects of protamine sulfate administration during cardiac surgery: a randomised controlled trial

Abstract Background One of the challenges during cardiac surgery is to keep patients fully anticoagulated during the  time and reversing  at the end of surgery. For that purpose, heparin and its approved..

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Role of Acquired Von Willebrand Syndrome in Patients Treated Using Impella RP® Devices: A Retrospective Cohort Study

Abstract Background: Axial flow pumps are standard treatment in cases of cardiogenic shock and high-risk interventions in cardiology and cardiac surgery, although the optimal anticoagulation strategy remains unclear. We evaluated whether..

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Patient blood management in cardiac surgery: The “Granducato algorithm”

Abstract Background Patients undergoing cardiac surgery are subject to severe alterations of the coagulation system. The four cardiac surgery centers in Tuscany (Italy) structured and shared an algorithm (Granducato Patient..

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Use of bivalirudin for anticoagulation in pediatric extracorporeal membrane oxygenation (ECMO)

Abstract This study describes the use of bivalirudin in children on extracorporeal membrane oxygenation (ECMO). Pediatric patients receiving bivalirudin were compared to patients receiving heparin as the anticoagulant on ECMO...

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Thrombin: A Pivotal Player in Hemostasis and Beyond

Abstract The serine protease thrombin, a naturally derived enzyme, plays a key role in hemostasis by converting fibrinogen to fibrin and activating coagulation factor XIII whereby the fibrin clot is..

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Native Aortic Root Thrombosis After Norwood Palliation for Hypoplastic Left Heart Syndrome

Abstract Background Norwood palliation for hypoplastic left heart syndrome typically results in retrograde perfusion of the native aortic root. This may predispose to native aortic root thrombosis (NART). Methods Patients..

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The use of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) in neonates: a systematic review

Abstract “Developmental hemostasis” refers to the dynamic process of gradual hemostatic maturation. Conventional coagulation tests seem to fail to accurately depict the in vivo hemostasis, while viscoelastic tests, thromboelastography (TEG),..

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Evaluation of the impact of HMS Plus on postoperative blood loss compared with ACT Plus in cardiac surgery

Abstract BACKGROUND: The standardized management of anticoagulation during the cardiopulmonary bypass seems inaccurate because of patients and surgeries variability. This study evaluates if an individualized management of heparin and protamine..

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A Standardized Approach Improves Outcomes of Extracorporeal Membrane Oxygenation for Postcardiotomy Shock

Abstract Postcardiotomy shock (PCS) has historically been associated with substantial morbidity and mortality. Mortality at discharge is reportedly more than 60%. We investigated the outcomes of our standardized approach to..

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Variability of three activated clotting time point-of-care systems in cardiac surgery: reinforcing available evidence

Abstract Background: Cardiac surgery with extracorporeal circulation (ECC) requires the administration of anticoagulant drugs to maintain ACT ranges 400–600 seconds, which requires exhaustive coagulation monitoring for which various point-of-care devices..

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Optimal protamine dosing after cardiopulmonary bypass: The PRODOSE adaptive randomised controlled trial

Abstract Background The dose of protamine required following cardiopulmonary bypass (CPB) is often determined by the dose of heparin required pre-CPB, expressed as a fixed ratio. Dosing based on mathematical..

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The Evolution of the Use of Extracorporeal Membrane Oxygenation in Respiratory Failure

Abstract Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency to support patients with acute respiratory failure, most commonly, and severe forms of acute respiratory distress syndrome (ARDS). The..

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Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States

Abstract OBJECTIVES:  To compare current practices within the United States of anticoagulation management and blood transfusion in neonatal and pediatric extracorporeal membrane oxygenation patients with a 2013 international report. DESIGN: ..

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Novel application of indocyanine green fluorescence imaging for real-time detection of thrombus in a membrane oxygenator

Abstract Extracorporeal membrane oxygenation (ECMO) plays an important role in the coronavirus disease 2019 (COVID-19) pandemic. Management of thrombi in ECMO is generally an important issue; especially in ECMO for..

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Validation of the relationship between coagulopathy and localization of hydroxyethyl starch on the vascular endothelium in a rat hemodilution model

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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Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation: Heparin Versus Bivalirudin

Abstract OBJECTIVES:  Extracorporeal membrane oxygenation is a life-sustaining therapy for severe respiratory failure. Extracorporeal membrane oxygenation circuits require systemic anticoagulation that creates a delicate balance between circuit-related thrombosis and bleeding-related..

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