Archives

thumbnail
0 comment

Navigating anticoagulation in heart transplantation with thrombin–antithrombin complex: when conventional monitoring fails

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 More
thumbnail
0 comment

Evaluation of Activated Clotting Time Response to Unfractionated Heparin in Vascular Surgery: An Observational Study

Abstract 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 More
thumbnail
0 comment

Sonorheometry Quantra QPlus Characteristics in Adult Cardiac Surgical Patients: An Observational Cohort Study

Abstract 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 More
thumbnail
0 comment

Incidence and Temporal Changes of Transfusion and Coagulation Management in Cardiac Surgery: Insights From the Netherlands Heart Registration

Abstract 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 More
thumbnail
0 comment

Efficacy and safety of prothrombin complex concentrate versus fresh frozen plasma in adult patients undergoing cardiac surgery: a systematic review…

Abstract 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 More
thumbnail
0 comment

Laboratory Monitoring Unfractionated Heparin Treatments: Unanswered Issues

Abstract 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 More
thumbnail
0 comment

The association of estimated citrate load with frozen plasma versus four-factor prothrombin complex concentrate for coagulopathy after cardiac surgery: a…

Abstract 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 More
thumbnail
0 comment

Heparin Dose-Response Curve for Heparin Dose Determination During Cardiopulmonary Bypass for Pediatric Cardiac Surgery: A Prospective Randomized Controlled Study

Abstract 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 More
thumbnail
0 comment

Development and Validation of an Integrated Artificial Intelligence-Powered Clinical Decision Support Application for Cardiac Critical Care: Combining Coagulation Management, Blood…

Abstract 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 More
thumbnail
0 comment

Coagulation-Friendly Environment in Cardiac Surgery: A Narrative Review

Abstract 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 More
thumbnail
0 comment

Development of a novel anticoagulant and fibrinolytic management monitoring method during extracorporeal circulation using clot-fibrinolysis waveform analysis: the effects of…

Abstract 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 More
thumbnail
0 comment

ROTEM versus conventional coagulation tests in evaluating coagulopathy and transfusion requirement in ECMO patients: A retrospective study

Abstract 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 More
thumbnail
0 comment

Safety of prolonged anticoagulation-free venovenous ECMO management beyond 72 hours in post-traumatic ARDS: A single-center retrospective cohort study

Abstract 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 More
thumbnail
0 comment

Incidence and Characteristics of Residual Heparin Effect in Cardiothoracic Surgical Patients using Sonorheometry Clot Time Ratio

Abstract 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 More
thumbnail
0 comment

Anticoagulation Monitoring Strategies During Cardiopulmonary Bypass in Patients With Antiphospholipid Syndrome: A Systematic Review

Abstract 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 More
thumbnail
0 comment

Heparin Activity Following Titration-Guided Protamine Reversal After Cardiopulmonary Bypass: Impact on Postoperative Bleeding

Abstract 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 More
thumbnail
0 comment

Considerations to practice a safe and minimal administration of heparin and protamine during cardiopulmonary bypass

Abstract 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 More
thumbnail
0 comment

Management of anticoagulation in patients with heparin-induced thrombocytopenia requiring cardiac surgery with cardiopulmonary bypass: guidance from the ISTH SSC on…

Abstract 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 More
thumbnail
0 comment

Standard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial

Abstract 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 More
thumbnail
0 comment

Anticoagulation Changes and Biochemical Signals Preceding Hospital-Acquired Infections in Pediatric Extracorporeal Support

Abstract 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 More
thumbnail
0 comment

Antidotes for Anticoagulation Reversal

Abstract 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 More
thumbnail
0 comment

2026 American Association for Thoracic Surgery Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in patients who undergo cardiac…

Abstract 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 More
thumbnail
0 comment

A Retrospective Analysis of Thromboelastometry and Conventional Laboratory Values in Nonsurgical and Noncardiac Surgery Patients: Not What One Might Expect…

Abstract 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 More
thumbnail
0 comment

Influence of Human Factors on Coagulation Management in Cardiac Surgery: A Retrospective Analysis

Abstract 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 More
thumbnail
0 comment

Comprehensive Coagulation Management in Cardiac Surgery: Anticoagulants, Heparin Resistance, Monitoring, and Bleeding Risks

Abstract 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 More
thumbnail
0 comment

FXII decline during cardiopulmonary bypass and the limits of routine coagulation assays: a prospective observational analysis

Abstract 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 More
thumbnail
0 comment

Evaluating Four HIT Prediction Scores After Cardiac Surgery With Cardiopulmonary Bypass: A Comparative Study

Abstract 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 More
thumbnail
0 comment

Anticoagulation Strategies in Adults Undergoing Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

Abstract 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 More
thumbnail
0 comment

Clinical Outcomes of Different Heparin Anticoagulation Monitoring Targets in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

Abstract 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 More
thumbnail
0 comment

2026 American Association for Thoracic Surgery Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in patients who undergo cardiac…

Abstract 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 More