Tags Archives: Anticoagulation

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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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Anticoagulation during extracorporeal membrane oxygenation: A narrative review

Abstract Extracorporeal Membrane Oxygenation (ECMO) is a technology that offers organ support for critically ill patients with respiratory and/or cardiac failure. Despite improvements in recent years in technology and the..

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A Pumpless Pediatric Artificial Lung Maintains Function for 72 h Without Systemic Anticoagulation Using the Nitric Oxide Surface Anticoagulation System

Abstract Background Children with end-stage lung disease are commonly managed with extracorporeal life support (ECLS) as a bridge to lung transplantation. A pumpless artificial lung (MLung) is a portable alternative..

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Anti-Xa assay monitoring improves the precision of anticoagulation in venovenous extracorporeal membrane oxygenation

Abstract Unfractionated heparin (UFH) is the most used anticoagulant in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO). Its therapeutic levels are monitored using activated partial thromboplastin time ratio (aPTTr) or..

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Prevalence of FXII-Deficiency and Its Relevance to Monitoring Anticoagulation in Adults Receiving Extracorporeal Membrane Oxygenation

Abstract During extracorporeal membrane oxygenation (ECMO) blood is exposed to artificial surfaces, resulting in contact activation of the intrinsic coagulation pathway initiated by coagulation factor XII (FXII). Little is known..

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Anticoagulation strategies in COVID-19 infected patients receiving ECMO support

Abstract Background: Hospitalized COVID-19 patients with hypoxemic respiratory failure may deteriorate despite invasive mechanical ventilation and thus require extracorporeal membrane oxygenation (ECMO) support. Unfractionated heparin (UFH) is the antithrombotic of..

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Commercial and novel anticoagulant ECMO coatings: a review

Abstract Extracorporeal membrane oxygenation (ECMO) is an invasive and last-resort treatment for circulatory and respiratory failure. Prolonged ECMO support can disrupt the coagulation and anticoagulation systems in a patient, leading..

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Efficacy of Prostacyclin Anticoagulation in Critically Ill Patients Requiring Extracorporeal Support: A Systematic Review and Meta-Analysis

Abstract Extracorporeal support modalities are highly prothrombotic. Anticoagulation is frequently used for patients receiving Continuous Renal Replacement Therapy (CRRT), Molecular Adsorbent Recirculating System (MARS), and Extracorporeal Membrane Oxygenation (ECMO). The..

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Anticoagulation for cardiopulmonary bypass, Part 2: alternatives and pathological states

Abstract Pathophysiology There are two types of HIT, depending on the absence or presence of an immune mediation. Type 1 is a non-immune-mediated direct activation of platelets by heparin that..

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Investigation of real-world heparin resistance and anticoagulation management prior to cardiopulmonary bypass: report from a nationwide survey by the Japanese…

Abstract Objective Heparin resistance is often encountered during cardiopulmonary bypass. Heparin dose and activated clotting time target values for the initiation of cardiopulmonary bypass are not yet universally standardized; further..

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Targeting the Contact Pathway of Coagulation for the Prevention and Management of Medical Device-Associated Thrombosis

Abstract Hemorrhage remains a major complication of anticoagulants, with bleeding leading to serious and even life-threatening outcomes in rare settings. Currently available anticoagulants target either multiple coagulation factors or specifically..

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Comparison of anticoagulation monitoring strategies for adults supported on extracorporeal membrane oxygenation: A systematic review

Abstract Background Anticoagulation is critical in patients supported on extracorporeal membrane oxygenation (ECMO). The appropriate monitoring strategies for heparin remain unclear. Objectives This systematic review aimed to compare the accuracy..

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Clues of incomplete reversal of heparin in cardiac surgery

Abstract Objectives In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these..

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Antithrombin Replacement and Extracorporeal Membrane Oxygenation: The time is ripe for a Simpler Solution

Abstract The use of extracorporeal membrane oxygenation (ECMO) circuit obligates the administration of systemic anticoagulation to avoid patient and circuit thrombosis. Identifying an optimal approach for achievement of target pharmacologic..

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The History of Extracorporeal Membrane Oxygenation and the Development of Extracorporeal Membrane Oxygenation Anticoagulation

Abstract Extracorporeal membrane oxygenation (ECMO) was first started for humans in early 1970s by Robert Bartlett. Since its inception, there have been numerous challenges with extracorporeal circulation, such as coagulation..

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Outcomes of heparinized adult veno-arterial extracorporeal membrane oxygenation patients managed with low and high activated partial thromboplastin time targets: A…

Abstract Introduction There are no randomized controlled trials comparing low and high activated partial thromboplastin time (aPTT) targets in heparinized adult veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) patients. Our systematic..

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Heparin Versus Bivalirudin for Anticoagulation in Adult Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

Abstract Extracorporeal membrane oxygenation (ECMO) poses unique thrombotic and hemorrhagic risks, and the optimal anticoagulant choice is unknown. We systematically searched Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and..

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