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Low- vs. Moderate-Intensity Anticoagulation for Venovenous Extracorporeal Membrane Oxygenation: The SAFE-ECMO Pilot Trial

Abstract Background Bleeding is a common and sometimes fatal complication of venovenous extracorporeal membrane oxygenation (ECMO). Whether lowering the intensity of anticoagulation during venovenous ECMO is safe or effective is..

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Anticoagulation in ECMO: Target Values to Reduce Hemorrhagic Complications in Adults. A Retrospective Cohort Study

Abstract The 2021 Adult and Pediatric Anticoagulation Guidelines for patients on extracorporeal membrane oxygenation (ECMO) recommend a target partial thromboplastin time (PTT) between 60 and 85 seconds when unfractionated heparin..

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Enhanced Hemodynamics of Anisometric TPMS Topology Reduce Blood Clotting in 3D Printed Blood Contactors

Abstract Artificial organs, such as extracorporeal membrane oxygenators, dialyzers, and hemoadsorber cartridges, face persistent challenges related to the flow distribution within the cartridge. This uneven flow distribution leads to clot..

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Survey of Extracorporeal Life Support Application in Lung Transplantation

Abstract Introduction Lung transplantation has been evolving since its inception in 1963. Over recent years, literature has suggested a shift in the perioperative strategy of mechanical support toward extracorporeal membrane..

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Blood Purification Membranes Used in Liquid–Gas Environments: Artificial Lungs

Abstract Extracorporeal membrane oxygenation (ECMO), the key component of which is a membrane oxygenator, known as the artificial lung, could provide irreplaceable respiratory support for patients with cardiopulmonary failure. The..

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Anticoagulation Monitoring Strategies During Extracorporeal Membrane Oxygenation (ECMO) Therapy – Differences Between Simultaneously Obtained Coagulation Tests: A Retrospective Single-Center Cohort…

Abstract Introduction During extracorporeal membrane oxygenation (ECMO) systemic anticoagulation with unfractionated heparin (UFH) is standard-of-care. However, there is uncertainty regarding optimal anticoagulation monitoring strategies. Methods We retrospectively investigated venovenous and..

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ECMO in Resource-Limited Settings: Challenges and the Way Forward

Introduction Extracorporeal Membrane Oxygenation (ECMO) has revolutionized the management of patients with severe cardiac and respiratory failure. Once considered a last-resort therapy, ECMO is now an integral part of critical..

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Optimizing Priming Solutions in Cardiopulmonary Bypass: Balancing Hemodynamics, Organ Protection, and Patient Outcomes

Introduction Cardiopulmonary bypass (CPB) is a life-saving technology that temporarily replaces the heart and lungs during cardiac surgery. The choice of priming solution plays a crucial role in maintaining hemodynamic..

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Isolated Limb Perfusion (ILP) and Hyperthermia in Cancer Treatment

Introduction Isolated Limb Perfusion (ILP) is a targeted chemotherapy technique used primarily for treating locally advanced limb malignancies, such as soft tissue sarcomas and melanoma. By isolating the limb’s vascular..

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Left Heart Bypass

Left Heart Bypass: An Overview Introduction Left Heart Bypass (LHB) is a surgical technique used to temporarily divert blood from the left side of the heart to maintain distal perfusion..

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Managing Anticoagulation in Cardiopulmonary Bypass: Best Practices

Cardiopulmonary bypass (CPB) is a cornerstone of modern cardiac surgery, enabling complex procedures by temporarily taking over the heart and lung functions. However, one of the most critical aspects of..

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Common Mistakes in Perfusion and How to Avoid Them.

Perfusionists play a critical role in cardiac surgery and extracorporeal support, ensuring optimal oxygenation and circulation during procedures. However, given the complexity of the field, even experienced professionals can make..

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The effects of changes in thrombocyte indices, on-on-pump time on prognosis in open heart surgery

Abstract Extracorporeal perfusion systems utilized in open-heart surgeries with cardiopulmonary bypass can affect multiple body systems. The primary adverse effects of Extracorporeal Perfusion Systems (EPS) on the hematological system include..

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Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia

Abstract Contact of blood with artificial surfaces triggers platelet activation. The aim was to compare platelet kinetics after venovenous extracorporeal membrane oxygenation (V-V ECMO) start and after system exchange in..

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Real-time prediction of heparin concentration in blood extracorporeal circulation by relaxation time distribution (RTD)

Abstract In blood extracorporeal circulations such as hemodialysis (HD) and extracorporeal membrane artificial lung (ECMO) during the surgical operation, the real-time and noninvasive prediction of heparin concentration c is necessary over the..

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Antithrombotic and Antimicrobial Potential of S-Nitroso-1-Adamantanethiol–Impregnated Extracorporeal Circuit

Abstract This study presents the utilization of a novel, highly lipophilic nitric oxide (NO) donor molecule, S-nitroso-1-adamantanethiol (SNAT), for developing an NO-emitting polymer surface aimed at preventing thrombus formation and bacterial..

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A road map of human vasculature

Abstract The blood vessel network transfers gas and nutrients throughout the body. In addition, vascular cells contribute to essential functions such as coagulation, immune regulation, angiogenesis and tissue repair, and..

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Andexanet Alfa–Associated Heparin Resistance in Cardiac Surgery: Mechanism and In Vitro Perspectives

Abstract BACKGROUND: Andexanet alfa (andexanet) is the only Food and Drug Administration–approved antidote for direct FXa (factor Xa) inhibitors but has been reported to cause resistance to unfractionated heparin (UFH)...

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Erythrocytes and Platelets Autotransfusion in High Hemorrhagic Risk Cardiac Surgery: A Single-Center Pilot Analysis of the Multicentric SEPIA Registry

Abstract Intraoperative cell salvage (IOCS) allows the collection, treatment, and retransfusion of shed blood from the surgical field and cardiopulmonary bypass (CPB) collector during cardiac surgery. This technique has been..

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Inadequate Anti–Factor Xa Levels With Daily 40-mg Enoxaparin After Cardiac Surgery

Abstract Background Cardiac surgery patients are at increased risk for venous thromboembolism (VTE). Prevention is the most critical strategy to reduce VTE-associated morbidity and death. However, there is a lack..

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A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas

Abstract Introduction There is no consensus on the dose of heparin to be used intraoperatively in cardiac myxomas, so the goal of this study was to look into the differences..

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Changes in various forms of fibronectin in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass – a prospective, observational…

Abstract Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) is associated with the transient activation of a systemic inflammatory response. Fibronectin (FN), an endogenous inflammatory mediator, is a key..

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Thromboelastography versus thromboelastometry for unfractionated heparin monitoring in adult patients on extracorporeal membrane oxygenation

Abstract Background: Monitoring the anticoagulant effect of unfractionated heparin (UFH) in extracorporeal membrane oxygenation (ECMO) patients is complex but critically important to balance the risks of treatment related bleeding and..

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Establishing an Extracorporeal Cardiopulmonary Resuscitation Program

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective..

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Experience with extracorporeal membrane oxygenation support in Latin America between 2016 and 2020

Abstract Objective To document the experience with ECMO therapy in healthcare institutions across Latin America between 2016 and 2020. Design Cross-sectional study. Setting Private and public health institutions from 7..

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Troubleshooting heparin resistance

Abstract The term heparin resistance is likely best defined as the failure of an appropriate dose of unfractionated heparin (UFH) to achieve a predetermined level of anticoagulation. Unfortunately, and despite..

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The role of extracorporeal membrane oxygenation in thoracic anesthesia

Abstract Purpose of review Circulatory and respiratory support with extracorporeal membrane oxygenation (ECMO) has gained widespread acceptance during high-end thoracic surgery. The purpose of this review is to summarize the..

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Inferior vena cava thrombosis in patients undergoing extracorporeal membrane oxygenation: a case series and literature review

Abstract Background Extracorporeal membrane oxygenation (ECMO) is mainly used for support of patients with cardiopulmonary collapse. The increasing use of ECMO has shown promising outcomes; however, it still carries the..

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Extracorporeal membrane oxygenation: unmet needs and perspectives

Abstract Extracorporeal Membrane Oxygenation (ECMO) has become an essential lifesaving intervention for individuals with severe cardiovascular and respiratory failure. Its application is expanding across several therapeutic contexts, surpassing conventional indications...

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Anticoagulation management during veno-venous ECMO support because of ARDS: Single-center experience

Abstract Background Patients with severe acute respiratory distress syndrome (ARDS) show a high mortality rate of up to 60 %. In such cases, extracorporeal membrane oxygenation (ECMO) support is often required,..

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