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Assessment of Heparin Anticoagulation Measured Using i-STAT and Hemochron Activated Clotting Time

Objective Adequate , measured using  (ACT), is important during vascular and cardiac surgeries. Unfractionated heparin is the most common  used. The purpose of this analysis was to compare the i-STAT ACT (iACT) to..

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An introduction to point-of-care testing in extracorporeal circulation and LVADs

Abstract There is a delicate balance between bleeding and clotting in patients on circuits such as ventricular assist devices or extracorporeal membrane oxygenation. Traditional coagulation tests, prothrombin time, activated partial..

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Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

Abstract OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have..

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Heparin–protamine balance after neonatal cardiopulmonary bypass surgery

Abstract Essentials   Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..

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Patient Blood Management in Pediatric Cardiac Surgery: A Review

Abstract Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant..

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Thoracic Bleeding Complications in Patients With Venovenous Extracorporeal Membrane Oxygenation

Abstract Background Patients with respiratory failure are treated more frequently with venovenous  (vv-ECMO). These patients are at risk for bleeding due to complex multifactorial  resulting from the . Methods A retrospective analysis was conducted..

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Bleeding, Thrombosis, and Transfusion With Two Heparin Anticoagulation Protocols in Venoarterial ECMO Patients

Abstract Objective To compare the incidence of bleeding and  between adult venoarterial (VA)  (ECMO) patients managed with an  (ACT)-guided heparin  protocol and activated  (aPTT) protocol. Design . Setting Tertiary care, academic medical center...

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Prospective, Randomized Un-Blinded Three Arm Controlled Study in Coronary Artery Revascularization with Minimal Invasive Extracorporeal Circulation Systems (MiECC): Surrogate Parameter…

Abstract Objectives: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused..

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Feasibility of autologous intraoperative blood collection and retransfusion in small children with complex congenital heart defects undergoing cardiopulmonary bypass

Abstract Introduction Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may..

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Effects of sodium citrate, citric acid and lactic acid on human blood coagulation

Abstract Introduction: Citric acid infusion in extracorporeal blood may allow concurrent regional anticoagulation and enhancement of extracorporeal CO2 removal. Effects of citric acid on human blood thromboelastography and aggregometry have never..

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Anticoagulation with VADs and ECMO: walking the tightrope

Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac..

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Heparin–protamine balance after neonatal cardiopulmonary bypass surgery

Abstract Essentials   Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..

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Chemical and pharmacological aspects of neutralization of heparins from different animal sources by protamine

Abstract Background Protamine neutralization is an essential step for the safe use and inactivation of the unfractionated heparin (UFH) that is widely employed in surgical and non-surgical procedures involving extracorporeal..

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Surgical Technique Influences HeartMate II Left Ventricular Assist Device Thrombosis

Background  of the HeartMate II (HM2 [Thoratec Corporation, Pleasanton, CA]) is a potentially devastating complication. While attention has been focused on  strategies to prevent this complication, the impact of surgical technique..

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Treatment of device thrombus in the HeartWare HVAD: Success and outcomes depend significantly on the initial treatment strategy

Background Pump thrombosis is a major adverse event in patients supported with a left ventricular assist device (LVAD). Treatment approaches include device exchange, lytic therapy, or augmentation of anticoagulation or..

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Microvascular Alterations During Cardiac Surgery Using a Heparin or Phosphorylcholine-Coated Circuit

Abstract Objective Heparin biocompatible coating frequently is used to reduce inflammation and blood coagulation during cardiopulmonary bypass (CPB) in cardiac surgery. Whether heparin coating is protective or damaging to the..

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Effect of sugammadex on coagulation as detected by rotational thromboelastometry in morbidly obese patients

Abstract BACKGROUND Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available..

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Low flow rate alters haemostatic parameters in an ex-vivo extracorporeal membrane oxygenation circuit

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving modality used to manage cardiopulmonary failure refractory to conventional medical and surgical therapies. Despite advances in ECMO equipment, bleeding and thrombosis..

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Identification of mesothelial cells in intraoperative blood salvage

Abstract Intraoperative auto-transfusion with the use of cell saver systems is routinely used to reduce the rate of packed red blood transfusion in major surgery. Nevertheless some concerns have been..

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Inflammation and coagulation following minimally invasive extracorporeal circulation technologies

Abstract Minimally invasive extracorporeal perfusion technologies are based on the use of a minimally invasive extracorporeal circulation (MiECC) system. This includes a closed CPB circuit; biologically inert blood contact surfaces;..

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Effects of Implementing Rotational Thromboelastometry in Cardiac Surgery: A Retrospective Cohort Study

Abstract Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac..

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Hematologic Evaluation of Intraoperative Autologous Blood Collection and Allogeneic Transfusion in Cardiac Surgery

Abstract Background Acute normovolemic hemodilution is recommended as a technique to reduce allogeneic red blood cell (RBC) transfusions in cardiac surgery, but its efficacy to reduce non‐RBC transfusion has not..

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In vitro head-to-head comparison of anticoagulation properties of two heparin brands in a human blood miniature mock loop

Abstract OBJECTIVES The first aim was the development of a human blood miniature mock-loop system consisting of 2 identical extracorporeal circuits, which enable systematic head-to-head comparisons of test substances. In..

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Chemical and pharmacological aspects of neutralization of heparins from different animal sources by protamine

Abstract Background Protamine neutralization is an essential step for the safe use and inactivation of the unfractionated heparin (UFH) that is widely employed in surgical and non‐surgical procedures involving extracorporeal..

Read More
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0 comment

Prospective, Randomized Un-Blinded Three Arm Controlled Study in Coronary Artery Revascularization with Minimal Invasive Extracorporeal Circulation Systems (MiECC): Surrogate Parameter…

Abstract Objectives: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused..

Read More
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0 comment

Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

Abstract OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have..

Read More
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Utility of thromboelastography versus routine coagulation tests for assessment of hypocoagulable state in patients undergoing cardiac bypass surgery

Abstract Introduction: Peri-operative monitoring of coagulation is important to diagnose potential cause of hemorrhage, to manage coagulopathy and guide treatment with blood products in patients undergoing cardiac surgery with cardiopulmonary bypass...

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The use of acute normovolemic hemodilution in paediatric cardiac surgery

Abstract Background Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood‐loss surgeries. We determined the association between ANH and the..

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Predictors of Heparin Resistance Before Cardiovascular Operations in Adults

Background Heparin resistance (HR) is often encountered during cardiovascular operations that require cardiopulmonary bypass. Clinical risk factors and the mechanism underlying heparin resistance are yet to be determined. The aim..

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Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer’s chase technique – a…

Abstract Introduction: Residual pump blood from the cardiopulmonary bypass (CPB) circuit is often collected into an infusion bag (IB) and re-transfused. An alternative is to chase the residual blood into..

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