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Carbon dioxide dialysis in a swine model utilizing systemic and regional anticoagulation

Abstract Background Extracorporeal carbon dioxide removal (ECCO2R) has been gaining interest to potentially facilitate gas transfer and equilibrate mild to moderate hypercapnic acidosis, when standard therapy with non-invasive ventilation is..

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Detection of coagulopathy in paediatric heart surgery [DECISION study]: study protocol

Abstract Background Each year in the UK, ≈3000 children undergo major cardiac surgery requiring cardiopulmonary bypass. Approximately 40 % of these experience excessive bleeding necessitating red cell transfusion or treatment with..

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Use of a fixed, body weight-unadjusted loading dose of unfractionated heparin for extracorporeal cardiopulmonary resuscitation

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is being used increasingly in the emergency and critical care field in Japan. A major complication of ECPR is bleeding; however, the optimal initial..

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Randomized, Double‐Blinded, Placebo‐Controlled Trial of Fibrinogen Concentrate Supplementation After Complex Cardiac Surgery

Abstract Background Postoperative bleeding after heart operations is still a common finding, leading to allogeneic blood products transfusion. Fibrinogen and coagulation factors deficiency are possible determinants of bleeding. The experimental..

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Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation

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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Is the use of hydroxyethyl starch as priming solution during cardiac surgery advisable? A randomized, single-center trial

Abstract Introduction: The use of cardiopulmonary bypass (CPB) leads to increased fluid filtration and edema. The use of artificial colloids to counteract fluid extravasation during cardiac surgery is controversial. Beneficial..

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Bleeding during veno-venous ECMO cannot reliably be predicted by rotational thrombelastometry (ROTEM™)

Abstract Introduction: Veno-venous extracorporeal membrane oxygenation (vvECMO) used for respiratory support is associated with clinical bleeding in at least one third of patients. Mechanisms promoting bleeding, like acquired von Willebrand..

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Relationship Between Transfusion of Blood Products and the Incidence of Thrombotic Complications in Neonates and Infants Undergoing Cardiac Surgery

Abstract Objectives The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic..

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Bleeding and thrombosis associated with ventricular assist device therapy

Abstract Over the past decade, continuous-flow rotary pumps have dramatically improved survival for patients with advanced . Bleeding and thrombosis, however, continue to be the Achilles heel of  (LVAD) therapy. There is..

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International survey on the perioperative management of pulmonary endarterectomy: the perfusion perspective

Abstract Introduction: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are..

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Silicon Micropore‐Based Parallel Plate Membrane Oxygenator

Abstract Extracorporeal membrane oxygenation (ECMO) is a life support system that circulates the blood through an oxygenating system to temporarily (days to months) support heart or lung function during cardiopulmonary..

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Hemodilution on Cardiopulmonary Bypass: Thromboelastography Patterns and Coagulation-Related Outcomes

Abstract Objective  has been associated with both  and  in studies based on  (TEG). Severe hemodilution during  (CPB) is a risk factor for morbidity in cardiac surgery. This study investigated the effects of different degrees..

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Thromboelastography during coronary artery bypass grafting surgery of severe hemophilia A patient – the effect of heparin and protamine on…

Abstract Coronary artery bypass grafting surgery (CABG) in hemophilia patients is challenging. Thromboelastography (TEG) is useful to assess hemostasis perioperatively. A patient with severe hemophilia A underwent CABG with TEG studies...

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Anticoagulation and Transfusions Management in Veno-Venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: Assessment of Factors Associated With Transfusion…

Abstract Purpose: We describe an approach for anticoagulation and transfusions in veno-venous–extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. Methods: Observational study..

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Utility of Sonoclot in Prediction of Postoperative Bleeding in Pediatric Patients Undergoing Cardiac Surgery for Congenital Cyanotic Heart Disease: A…

Abstract Objectives To assess the utility of Sonoclot in prediction of  in pediatric patients undergoing cardiac surgery with  for . Design Prospective, . Setting Single university hospital. Participants Eighty-seven pediatric patients undergoing cardiac surgery..

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Citrate pathophysiology and metabolism

Abstract By chelating ionized  allows  circuit  without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of  and platelets. Citrate clearance by  (Krebs cycle) is not modified by renal..

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Platelet, Red Cell, and Endothelial Activation and Injury During Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) can be lifesaving but suffers from high rates of bleeding and repeated transfusions. Current monitoring of blood cell damage during ECMO is limited to platelet..

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GTH 2021 State of the Art—Cardiac Surgery: The Perioperative Management of Heparin-Induced Thrombocytopenia in Cardiac Surgery

Abstract Heparin-induced thrombocytopenia (HIT) is a severe, immune-mediated, adverse drug reaction that paradoxically induces a prothrombotic state. Particularly in the setting of cardiac surgery, where full anticoagulation is required during..

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The Impact and Statistical Analysis of a Multifaceted Anticoagulation Strategy in Children Supported on ECMO: Performance and Pitfalls

Abstract Background: We sought to determine whether the introduction of a new anticoagulation protocol improved the frequency with which target anticoagulation parameters were met in children supported with extracorporeal membrane..

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Extracorporeal membrane oxygenation improves coagulopathy in an experimental traumatic hemorrhagic model

Abstract Purpose Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation..

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Externally visible thrombus partially predicts internal thrombus deposition in extracorporeal membrane oxygenators

Abstract Aim: We sought to quantify the location and volume of thrombus in used hollow-fiber membrane oxygenators and correlate the volume of thrombus with patient demographics, flow characteristics and anticoagulation..

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The Munich Lung Transplant Group: Intraoperative Extracorporeal Circulation in Lung Transplantation

Abstract Background This retrospective single-center study aimed to analyze transfusion requirements, coagulation parameters, and outcome parameters in patients undergoing lung transplantation (LuTx) with intraoperative extracorporeal circulatory support, comparing cardiopulmonary bypass..

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Effects of circuit albumin coating on coagulation and inflammatory response for patients receiving aortic arch replacement: a randomized controlled trial

Abstract Objective: To investigate whether human serum albumin coating before cardiopulmonary bypass (CPB) could improve platelet function and hemostasis and mitigate the inflammatory response among patients receiving aortic arch replacement..

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Comparison of Thrombelastography-Derived Fibrinogen Values at Rewarming and Following Cardiopulmonary Bypass in Cardiac Surgery Patients

Abstract BACKGROUND:  The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest..

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Preoperative hemostatic testing and the risk of postoperative bleeding in coronary artery bypass surgery patients

Abstract BACKGROUND We sought to assess predictability of excessive bleeding using thrombelastography (TEG), multiplate impedance aggregometry, and conventional coagulation tests including fibrinogen in patients undergoing coronary artery bypass graft (CABG)..

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Bivalirudin for Alternative Anticoagulation in Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Background: Extracorporeal membrane oxygenation (ECMO) offers therapeutic options in refractory respiratory and/or cardiac failure. Systemic anticoagulation with heparin is routinely administered. However, in patients with heparin-induced thrombocytopenia or heparin..

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Evaluation of a New Sonoclot Device for Heparin Management in Cardiac Surgery

Abstract Background: Sonoclot is used to measure kaolin-based activated clotting time (kACT) for heparin management. Apart from measuring kACT, the device assesses the patient’s coagulation status by glass bead–activated tests..

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Disseminated Intravascular Coagulation: A Practical Approach

Abstract Anesthesiologists may encounter patients with disseminated intravascular coagulation, a potential complication of severe sepsis or major trauma. This practical guide discusses the clinical approach, laboratory diagnosis, and current management..

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Integral Use of Thromboelastography With Platelet Mapping to Guide Appropriate Treatment, Avoid Complications, and Improve Survival of Patients With Coronavirus…

Abstract Objectives:  Coagulopathy of coronavirus disease 2019 is largely described as hypercoagulability, yet both thrombotic and hemorrhagic complications occur. Although therapeutic and prophylactic anticoagulant interventions have been recommended, empiric use..

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Optimizing Thrombin Generation with 4-Factor Prothrombin Complex Concentrates in Neonatal Plasma After Cardiopulmonary Bypass

Abstract BACKGROUND:  Bleeding is a serious complication after pediatric cardiopulmonary bypass (CPB) that is associated with an increase in perioperative morbidity and mortality. Four-factor prothrombin complex concentrates (4F-PCCs) have been..

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