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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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Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-induced infection, the cause of coronavirus disease 2019 (COVID-19), is characterized by acute clinical pathologies, including various coagulopathies that may be accompanied..

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Comparison of Hemostatic Changes in Pump-driven Extracorporeal Carbon Dioxide Removal and Venovenous Extracorporeal Membrane Oxygenation

Abstract Extracorporeal carbon dioxide removal (ECCO2R) has gained widespread use as a supposedly less invasive alternative for hypercapnic respiratory failure besides venovenous extracorporeal membrane oxygenation (VV ECMO). Despite technological advances,..

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Coagulation activation during extracorporeal membrane oxygenation (ECMO)

Abstract Introduction  (ECMO) can be life-saving, but suffers from  in the circuit with associated risks of  occlusion,  and . The formation of thrombin is the key step to thrombus formation and two factors are..

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Combining Heparin and a FX/Xa Aptamer to Reduce Thrombin Generation in Cardiopulmonary Bypass and COVID-19

Abstract Known limitations of unfractionated heparin (UFH) have encouraged the evaluation of anticoagulant aptamers as alternatives to UFH in highly procoagulant settings such as cardiopulmonary bypass (CPB). Despite progress, these..

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Blood Protection Method: Retrograde Autologous Prime

Blood Protection Method: Retrograde Autologous Prime   In order to carry out open heart surgery, the functions of the heart and lungs must be stopped and the blood inside the..

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Efficacy of Bivalirudin for Therapeutic Anticoagulation in COVID-19 Patients Requiring ECMO Support

Abstract Objectives The  (COVID-19) pandemic has been associated with cases of refractory  (ARDS) sometimes requiring support with  (ECMO).  can be used for  in patients on ECMO support, but its efficacy and safety in patients with..

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The Interplay of Inflammation and Coagulation in COVID-19 Patients Receiving Extracorporeal Membrane Oxygenation Support

Abstract Objective Bleeding and thrombosis are common complications during Extracorporeal Membrane Oxygenation (ECMO) support for COVID-19 patients. We sought to examine the relationship between inflammatory status, coagulation effects, and observed..

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Neurological Complications in COVID-19 Patients With ECMO Support: A Systematic Review and Meta-Analysis

Abstract Background Patients with  (COVID-19)-related  (ARDS) increasingly receive  (ECMO) support. While ECMO has been shown to increase risk of stroke, few studies have examined this association in COVID-19 patients. Objective We conducted a..

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The Effectiveness of Three Different Curricular Models to Teach Fundamental ECMO Specialist Skills to Entry Level Perfusionists

Abstract The dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) over the last decade with the concomitant need for ECMO competent perfusionists has raised questions of how well..

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Renal and Cerebral Hypoxia and Inflammation During Cardiopulmonary Bypass

Abstract Cardiac surgery-associated acute kidney injury and brain injury remain common despite ongoing efforts to improve both the equipment and procedures deployed during cardiopulmonary bypass (CPB). The pathophysiology of injury..

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Blood Pumps for Extracorporeal Membrane Oxygenation: Platelet Activation During Different Operating Conditions

Abstract Extracorporeal membrane oxygenation (ECMO) is a therapy used in severe cardiopulmonary failure. Blood is pumped through an artificial circuit exposing it to nonphysiologic conditions, which promote platelet activation and..

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2021 ELSO Adult and Pediatric Anticoagulation Guidelines

Abstract Anticoagulation is necessary for most pediatric and adult extracorporeal membrane oxygenation (ECMO) patients to prevent circuit clotting. Inherently, the most common side effect of anticoagulation is bleeding. Anticoagulation during..

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Apical thrombus

Always check the apex, even if you don't see any regional wall motion abnormalities! This was an LV apical thrombus resolved after anticoagulation. LV thrombus can occur within 24 h after..

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