Tags Archives: Anticoagulation

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Silk-based multilayer coatings for anticoagulation and durability improvement in ECMO hollow fiber membranes

Abstract In clinical extracorporeal membrane oxygenation (ECMO), prolonged blood residence time in oxygenators can lead to thrombus formation and complications. Heparin-based bioactive coatings are commonly used for anticoagulation, but prolonged..

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Effectiveness and safety of bivalirudin anticoagulation therapy in adult patients receiving extracorporeal membrane oxygenation: A systematic review and meta-analysis

Abstract Background:  Compared to heparin, there is limited evidence of the benefits of bivalirudin in the patients with extracorporeal membrane oxygenation (ECMO). Methods:  We searched for studies comparing bivalirudin anticoagulation..

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Anticoagulation Monitoring During Extracorporeal Membrane Oxygenation: A Narrative Review

Abstract The advancement of  has introduced a new dimension to managing patients who do not respond to conventional treatment of severe .  (ECMO) is a specialized temporary life support that serves as a..

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Anticoagulate the Circuit, Not the Patient: Nitric Oxide Reduces Thrombus Formation During Extracorporeal Carbon Dioxide Removal

Abstract Solutions to reduce the need for systemic anticoagulation during extracorporeal life support would improve safety and utility. The study objective was to evaluate the safety and efficacy of a..

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Comparative Analysis of Thrombosis in ECPella Patients Between Bivalirudin versus Heparin Anticoagulation Strategies

Abstract Objective To review and compare the frequency of thrombus and adverse events in patients treated with heparin or bivalirudin systemic anticoagulation strategies supported on combined venoarterial extracorporeal membrane oxygenation..

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Analysis of the feasibility of a low-anticoagulation strategy in patients undergoing post-cardiotomy extracorporeal membrane oxygenation: a retrospective cohort study

Abstract Background Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients after cardiac surgery; however, anticoagulation management has consistently been challenging. This study aimed to explore the feasibility of a..

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Navigating coagulation: Key markers in the first 24 hours of pediatric ECMO

Abstract Background Anticoagulation in pediatric extracorporeal membrane oxygenation (ECMO) presents unique challenges due to developmental hemostasis, coagulation factor production, and response to anticoagulants. This process requires close monitoring to prevent..

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Low- vs. Moderate-Intensity Anticoagulation for Venovenous Extracorporeal Membrane Oxygenation: The SAFE-ECMO Pilot Trial

Abstract Background Bleeding is a common and sometimes fatal complication of venovenous extracorporeal membrane oxygenation (ECMO). Whether lowering the intensity of anticoagulation during venovenous ECMO is safe or effective is..

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Anticoagulation in ECMO: Target Values to Reduce Hemorrhagic Complications in Adults. A Retrospective Cohort Study

Abstract The 2021 Adult and Pediatric Anticoagulation Guidelines for patients on extracorporeal membrane oxygenation (ECMO) recommend a target partial thromboplastin time (PTT) between 60 and 85 seconds when unfractionated heparin..

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Anticoagulation Monitoring Strategies During Extracorporeal Membrane Oxygenation (ECMO) Therapy – Differences Between Simultaneously Obtained Coagulation Tests: A Retrospective Single-Center Cohort…

Abstract Introduction During extracorporeal membrane oxygenation (ECMO) systemic anticoagulation with unfractionated heparin (UFH) is standard-of-care. However, there is uncertainty regarding optimal anticoagulation monitoring strategies. Methods We retrospectively investigated venovenous and..

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Managing Anticoagulation in Cardiopulmonary Bypass: Best Practices

Cardiopulmonary bypass (CPB) is a cornerstone of modern cardiac surgery, enabling complex procedures by temporarily taking over the heart and lung functions. However, one of the most critical aspects of..

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Anticoagulation management during veno-venous ECMO support because of ARDS: Single-center experience

Abstract Background Patients with severe acute respiratory distress syndrome (ARDS) show a high mortality rate of up to 60 %. In such cases, extracorporeal membrane oxygenation (ECMO) support is often required,..

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Anticoagulation in Extracorporeal Membrane Oxygenation for Trauma: Striking a Balance

Abstract Extracorporeal membrane oxygenation in a venovenous configuration (VV-ECMO) is increasingly recognized as an important therapeutic option for patients with severe acute respiratory distress syndrome (ARDS). Accumulating scientific evidence as well..

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Between a rock and a hard place: anticoagulation management for ECMO

Abstract Anticoagulation is an essential component of optimal extracorporeal membrane oxygenation (ECMO) management. Unfractionated heparin is still the anticoagulant of choice in most centers due to longstanding familiarity with the..

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Association of Activated Clotting Time–Guided Anticoagulation with Complications during Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-Analysis

Abstract Objective Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to reduce the risk of thromboembolic events. Despite its historic role, activated clotting time (ACT) remains a widely used heparin monitoring..

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Cardiopulmonary bypass in a pediatric patient with factor XII deficiency

Abstract The safe use of cardiopulmonary bypass (CPB) relies upon the ability to administer, monitor, and reverse anticoagulation. Although rare, the factor XII deficient patient creates a challenge for the..

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Thromboembolic Complications in Continuous Versus Interrupted Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation: A Multicenter Study

Abstract OBJECTIVES:  Continuous, therapeutic anticoagulation is the standard of care for patients on extracorporeal membrane oxygenation (ECMO). The risks of hemorrhage exacerbated by anticoagulation must be weighed with the thrombotic..

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Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

Abstract OBJECTIVES:  To identify and prioritize research questions for anticoagulation and hemostasis management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE)..

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Anticoagulant Medications: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

Abstract OBJECTIVES:  To derive systematic-review informed, modified Delphi consensus regarding the medications used for anticoagulation for pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE (PEACE). DATA SOURCES: ..

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Low Versus Standard Intensity Heparin Protocols in Adults Maintained on Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study

Abstract Background:  Patients maintained on extracorporeal membrane oxygenation (ECMO) often require systemic anticoagulation to prevent circuit clotting and systemic thromboembolic complications. The optimal intensity of anticoagulation to balance the risk..

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Impact of C-reactive Protein on Anticoagulation Monitoring in Extracorporeal Membrane Oxygenation

Abstract Objective To evaluate the impact of inflammation on  monitoring for patients supported with  (ECMO). Design Prospective single-center . Setting University-affiliated tertiary care academic medical center. Participants Adult venovenous and venoarterial ECMO patients..

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Rethinking Coagulation Activation during Extracorporeal Membrane Oxygenation: Insights from the Case of Mr. Hageman

Abstract Blood surface interfacing that occurs within the extracorporeal membrane oxygenation (ECMO) circuit initiates contact activation, an important hemostatic pathway initiated by the Hageman factor, also called factor XII. Factor..

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Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study

Abstract Introduction Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation..

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Anti-Xa-guided Anticoagulation With Unfractionated Heparin and Thrombosis During Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-analysis

Abstract Objective The initiation of extracorporeal membrane oxygenation (ECMO) triggers complex coagulation processes necessitating systemic anticoagulation. Therefore, anticoagulation monitoring is crucial to avoid adverse events such as thrombosis and hemorrhage...

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Anticoagulation Strategies during Extracorporeal Membrane Oxygenation: A Narrative Review

Abstract The development of extracorporeal life support technology has added a new dimension to the care of critically ill patients who fail conventional treatment options. Extracorporeal membrane oxygenation (ECMO)—specialized temporary..

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Anticoagulation Management in V-V ECMO Patients: A Multidisciplinary Pragmatic Protocol

Abstract Background: Extracorporeal membrane oxygenation (ECMO) is a complex procedure affecting both the risk of thrombosis and bleeding. High-quality data to personalize anticoagulation management in ECMO are lacking, resulting in..

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Anticoagulation Can Be Held in Traumatically Injured Patients on Veno-Venous Extracorporeal Membrane Oxygenation Support

Abstract Traumatic injury is associated with several pulmonary complications, including pulmonary contusion, transfusion-related acute lung injury (TRALI), and the development of acute respiratory distress syndrome (ARDS). There is a lack..

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The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative (PEACE) Consensus Conference

Abstract OBJECTIVES:  To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation..

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Anticoagulation in ECMO patients: an overview

Abstract Extracorporeal membrane oxygenation (ECMO) is a form of cardiorespiratory support, and is being increasingly used to support refractory heart and respiratory failure. It involves draining blood from the vascular..

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Epidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database…

Abstract Introduction Due to the risk of thrombosis, nearly all children supported by extracorporeal membrane oxygenation (ECMO) receive systemic anticoagulation. While heparin has traditionally been used, there are reports of..

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