Abstract Background Heart transplant recipients often face the clinical dilemma of coexisting bleeding and thrombotic risks postoperatively. Conventional anticoagulation monitoring parameters (e.g., platelet count, fibrinogen, D‑dimer, and anti‑Xa activity) frequently..
Read MoreAbstract Objectives Activated clotting time (ACT) is widely used to monitor intraoperative anticoagulation with unfractionated heparin (UFH) during vascular surgery, but the most informative ACT-derived metric and the optimal approach..
Read MoreAbstract BACKGROUND: Validation of the Quantra QPlus sonorheometry cartridge (Hemosonics Corporation) in cardiac surgical patients is limited. The primary aim of our study was to quantify the accuracy of the..
Read MoreAbstract Objectives To describe perioperative transfusion rates, hospital variability, temporal trends, and the association between red blood cell (RBC) transfusion and predefined risk factors in Dutch cardiac surgery. Design Nationwide..
Read MoreAbstract Background Postoperative bleeding is a common and potentially life-threatening complication following cardiac surgery, often exacerbated by multifactorial coagulopathy from cardiopulmonary bypass, hypothermia, and platelet dysfunction. While fresh frozen plasma..
Read MoreAbstract Unfractionated heparin (UFH) has long been an anticoagulant of choice. Despite the increasing use of low molecular weight heparin derivatives and more recently direct oral anticoagulants, UFH is still..
Read MoreAbstract Background Frozen plasma (FP) is the standard haemostatic therapy after cardiopulmonary bypass, but recent trials indicate that FP is inferior to four-factor prothrombin complex concentrate (PCC). Citrate content may..
Read MoreAbstract Objectives To determine whether individualized heparin dosing guided by a heparin dose-response (HDR) curve is noninferior to conventional weight-based dosing in achieving target activated clotting time (ACT) of ≥480..
Read MoreAbstract This study describes the development and preliminary validation of an integrated clinical decision support application (Cardiac Critical Care Advisor Pro, CCA Pro v6.0) that combines viscoelastic coagulation analysis, arterial..
Read MoreAbstract Perioperative bleeding remains a major complication in cardiac surgery and is associated with increased morbidity, mortality, and transfusion requirements. While patient blood management strategies and goal-directed hemostatic therapies have..
Read MoreAbstract Clot-fibrinolysis waveform analysis (CFWA) enables the simultaneous assessment of coagulation and fibrinolytic functions within a short timeframe. We evaluated the effects of commonly used anticoagulants on coagulation–fibrinolysis balance using..
Read MoreAbstract Introduction Critically ill ECMO patients face high bleeding risks from anticoagulation and other factors. Although viscoelastic tests, like ROTEM, are widely used to assess hemostasis, evidence for their superiority..
Read MoreAbstract Introduction Standard anticoagulation protocols for patients with trauma-related acute respiratory distress syndrome (TR-ARDS) undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO) are often inapplicable due to high bleeding risks. This study..
Read MoreAbstract Objectives To quantify the incidence of Quantra QPlus clot time ratio (CTR) elevation (>1.4) in cardiac surgical patients with suspected postoperative coagulopathy and to investigate the correlation between CTR..
Read MoreAbstract Objectives Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder that complicates anticoagulation during cardiovascular surgery requiring cardiopulmonary bypass (CPB). This systematic review aimed to characterize the anticoagulation monitoring strategies..
Read MoreAbstract Objectives To evaluate postoperative residual and reappearing heparin activity after low-dose, titration-guided protamine reversal following cardiopulmonary bypass (CPB) in elective coronary artery bypass grafting (CABG). Design Prospective, controlled clinical..
Read MoreAbstract A critical aspect of cardiopulmonary bypass (CPB) is achieving full anticoagulation to prevent thrombosis and consumptive coagulation (CCA). Systemic anticoagulation with heparin during CPB should be completely neutralized by..
Read MoreAbstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction characterized by thrombocytopenia and a high risk of thrombosis. Patients with HIT and a need for cardiac surgery with cardiopulmonary..
Read MoreAbstract Background In patients receiving extracorporeal membrane oxygenation (ECMO), standard practice is full-dose intravenous unfractionated heparin (UFH) targeting an activated partial thromboplastin time of 2·0–2·5 times baseline to reduce thrombotic..
Read MoreAbstract Hospital-acquired infection (HAI) is a major complication in pediatric patients on extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Infection detection is challenging, as traditional inflammatory markers..
Read MoreAbstract The global rise in anticoagulant use has increased the number of major bleeding events that warrant timely and effective pharmacologic reversal. Reversal strategies should be informed by the pharmacodynamic..
Read MoreAbstract Background: Heparin-induced thrombocytopenia (HIT) in patients who undergo cardiac surgery presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence..
Read MoreAbstract Background Thromboelastometry is often used to guide coagulation management, but validation outside cardiac surgery is limited. We evaluated correlations between thromboelastometry parameters and conventional laboratory tests in noncardiac patients..
Read MoreAbstract Objectives To determine if the administration of coagulation products in cardiac surgery depends on the anesthesiologist’s exposure/number of cases per year, being on-call the same night as the surgery,..
Read MoreAbstract Effective coagulation management is pivotal to optimizing outcomes in cardiac surgery, influencing bleeding risk, transfusion requirements, and overall perioperative safety. This comprehensive review examines current strategies, limitations, and emerging..
Read MoreAbstract Background The contact activation system is triggered when blood comes into contact with artificial surfaces. Cardiopulmonary bypass (CPB) induces such activation, however the extent of factor XII (FXII) reduction..
Read MoreAbstract Objectives To compare the diagnostic performance of 4 clinical prediction scores for heparin-induced thrombocytopenia (HIT) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Design Bicentric retrospective observational study...
Read MoreAbstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with severe cardiac or respiratory failure, but it is associated with a high risk of thrombotic and bleeding..
Read MoreAbstract Objectives This systematic review and meta-analysis aimed to evaluate clinical outcomes associated with different systemic heparin protocols (conservative v standard intensity) during extracorporeal membrane oxygenation (ECMO) support. Included studies comprised both..
Read MoreAbstract Background Heparin-induced thrombocytopenia (HIT) in patients who undergo cardiac surgery presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence..
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