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Low vs standardized dose anticoagulation regimens for extracorporeal membrane oxygenation: A meta-analysis

Abstract Background To compare the safety and efficacy of low-dose anticoagulation (LA) with that of standardized dose anticoagulation (SA) for patients supported with extracorporeal membrane oxygenation (ECMO). Methods PubMed, MEDLINE,..

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Changes in Coagulation and Fibrinolysis Systems During the Perioperative Period of Acute Type A Aortic Dissection

Abstract Background: Acute type A aortic dissection (ATAAD) has a high risk of perioperative bleeding and often requires extensive blood product infusions. Analysis of the changes in coagulation and fibrinolysis..

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Intraventricular Conundrum in a SARS-CoV-2–Positive Patient With Elevated Biomarkers of Myocardial Injury

Abstract We present a case of acute myocarditis with left ventricular dysfunction and intracavitary thrombosis in a 55-year-old man with severe acute respiratory syndrome coronavirus 2 infection (coronavirus disease 2019)..

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Comparison of 4-Factor Prothrombin Complex Concentrate With Frozen Plasma for Management of Hemorrhage During and After Cardiac Surgery

Abstract Importance  Approximately 15% of patients undergoing cardiac surgery receive frozen plasma (FP) for bleeding. Four-factor prothrombin complex concentrates (PCCs) have logistical and safety advantages over FP and may be a..

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Hypercoagulopathy, acquired coagulation disorders and anticoagulation before, during and after extracorporeal membrane oxygenation in COVID-19: a case series.

Abstract Background: Thromboembolism and bleeding contribute to Coronavirus disease 2019 (COVID-19)’s morbidity and mortality and are also frequent complications of venovenous extracorporeal membrane oxygenation (vvECMO). As the interaction of the..

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Heparin-Free Lung Transplantation on Venovenous Extracorporeal Membrane Oxygenation Bridge.

Abstract Extracorporeal membrane oxygenation (ECMO) bridge to lung transplantation (LuTX) exposes the patients to a high risk of perioperative bleeding secondary to systemic anticoagulation and coagulation factors deficiency. With this..

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Different mechanisms of oxygenator failure and high plasma von Willebrand factor antigen influence success and survival of venovenous extracorporeal membrane…

Abstract Objective Failure of membrane oxygenator (MO) function of venovenous extracorporeal membrane oxygenators (VV ECMO) remains problematic. The development of device-induced coagulation disorder (COD) or worsened gas transfer (WGT) necessitates..

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Anti-Xa activity and hemorrhagic events under extracorporeal membrane oxygenation (ECMO): a multicenter cohort study

Abstract Background Hemorrhagic events remain a major concern in patients under extracorporeal membrane oxygenation (ECMO) support. We tested the association between anticoagulation levels and hemorrhagic events under ECMO using anti-Xa..

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ECMO and anticoagulation management.

The learner will be able to discuss anticoagulation strategies for patients on ECMO.   

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ECMO. Joe Basha, CCP July 19, 2018

ECMO: Measurement Of Adequacy, Cannulation, North/South Complication, Anticoagulation And Weaning, And What Patients Can Be Woken Up And Extubated On VV ECMO?   

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Novel approach to measuring clot burden of an oxygenator during ECMO.

Joe presents data on the commonality of clot burden in the ECMO circuit and how difficult it is to detect without a tool that can directly measure intra-oxygenator volume in..

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Extracorporeal Membrane Oxygenation (ECMO) Anticoagulation.

Joe Basha, CCP and John Ingram, CCP talk about anticoagulation strategies for ECMO patients.  Joe and John discuss SCCM guidelines and their own experiences with different anticoagulation protocols.   

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Extracorporeal Membrane Oxygenation (ECMO) Anticoagulation.

Joe Basha, CCP and John Ingram, CCP talk about anticoagulation strategies for ECMO patients.  Joe and John discuss SCCM guidelines and their own experiences with different anticoagulation protocols.   

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Novel approach to measuring clot burden of an oxygenator during ECMO

Joe presents data on the commonality of clot burden in the ECMO circuit and how difficult it is to detect without a tool that can directly measure intra-oxygenator volume in..

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ECMO and anticoagulation management

The learner will be able to discuss anticoagulation strategies for patients on ECMO.   

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Argatroban Anticoagulation for Adult Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Background: Heparin is the widely used anti-coagulation strategy for patients on extracorporeal membrane oxygenation (ECMO). Nevertheless, heparin-induced thrombocytopenia (HIT) and acquired anti-thrombin (AT) deficiency preclude the use of heparin..

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2020 ESC Guidelines for the management of Adult Congenital Heart Disease

  Since the previous version of the Guidelines on the management of grown-up congenital heart disease (CHD) was published in 2010, new evidence has accumulated for this patient group, particularly..

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Viscoelastic Coagulation Monitor as a Novel Device to Assess Coagulation at the Bedside. A Single-Center Experience During the COVID-19 Pandemic

Abstract Viscoelastic coagulation monitor (VCM) is a portable device developed to evaluate the viscoelastic properties of whole blood activated by contact with glass. In this study, VCM was employed to analyze..

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Improving Hemocompatibility: How Can Smart Surfaces Direct Blood To Fight against Thrombi

Abstract Nature utilizes endothelium as a blood interface that perfectly controls hemostasis, preventing the uncontrolled formation of thrombi. The management of positive and negative feedback that finely tunes thrombosis and..

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Cardiopulmonary bypass in a child with severe Factor XII deficiency

Abstract Factor XII (FXII) deficiency presents as a prolonged activated partial thromboplastin time (aPTT) but is not associated with clinically significant bleeding. Activated clotting time (ACT) is used routinely to..

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Heparin-Induced Thrombocytopenia

Abstract Heparin-induced thrombocytopenia is an immune-mediated disorder caused by antibodies that recognize complexes of platelet factor 4 and heparin. Thrombosis is a central and unpredictable feature of this syndrome. Despite..

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Association of D-dimer and Fibrinogen With Hypercoagulability in COVID-19 Requiring Extracorporeal Membrane Oxygenation

Abstract Background: D-dimer concentration has been used by institutions to identify candidates for intensified anticoagulant treatment for venous thromboembolism prevention and for the mitigation of the microthrombotic complications associated with..

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Minimal invasive extracorporeal circulation preserves coagulation integrity

Abstract Introduction: Coagulopathy after cardiac surgery is a serious multifactorial complication that results in postoperative bleeding requiring transfusion of red blood cells and procoagulant products. Use of cardiopulmonary bypass represents..

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Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation

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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Balancing the Blood Component Transfusion Ratio for High- and Ultra High–Dose Cell Salvage Cases

Abstract Objective To assess the ratio of non-red blood cell to red blood cell components required to avoid coagulopathy when transfusing large amounts of salvaged blood using laboratory test–guided therapy...

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Bivalirudin anticoagulation for left ventricular assist device implantation on an extracorporeal life support system in patients with heparin-induced thrombocytopenia antibodies

Abstract OBJECTIVES Heparin-induced thrombocytopenia (HIT) requires alternative anticoagulation strategies. We investigated outcomes in patients with HIT antibodies undergoing low-dose bivalirudin anticoagulation during left ventricular assist device implantation on an extracorporeal..

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ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

Abstract The interaction between the patient and the ECMO (extracorporeal membrane oxygenation) circuit initiates a significant coagulation and inflammatory response due to the large surface area of foreign material contained..

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Veno-arterial extracorporeal membrane oxygenation without therapeutic anticoagulation for intra-operative cardiopulmonary support during lung transplantation

Abstract Cardiopulmonary support is frequently required during lung transplantation. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been recently shown to be an acceptable and, perhaps, safer alternative to cardiopulmonary bypass machine..

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Predictors of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation: an observational cohort study

Abstract Background Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH..

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Key Points for Curbing Cardiopulmonary Bypass Inflammation

Abstract PURPOSE: Cardiopulmonary bypass (CPB) procedures are thought to activate systemic inflammatory reaction syndrome (SIRS). Strategies to curb systemic inflammation have been previously described. However, none of them is adequate,..

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