Tags Archives: Anticoagulation

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Nanoconjugated anticoagulant coating with blood repellency for extracorporeal circulation in cardiothoracic surgery

Abstract Coating strategies play a pivotal role in anticoagulation management during extracorporeal circulation. While heparin-based coatings remain the most widely used, their limited anticoagulant efficacy may lead to adverse events..

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Prolonged Extracorporeal Membrane Oxygenation Without Systemic Anticoagulation in Sheep

Abstract Clinically significant bleeding is a common complication of extracorporeal membrane oxygenation (ECMO), with bleeding observed in upwards of 40% of patients. Bleeding is strongly associated with systemic anticoagulation, which..

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Contemporary Clinical Practices in Anticoagulation Management During Cardiopulmonary Bypass: A Europe-Wide Survey

Abstract Objectives Clinical practice in anticoagulation management, particularly in heparin administration, monitoring, reversal and haemostasis, is known to differ significantly. To better characterize this variability, we conducted a Europe-wide survey..

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Contemporary Clinical Practices in Anticoagulation Management During Cardiopulmonary Bypass: A Europe-Wide Survey

Abstract Objectives Clinical practice in anticoagulation management, particularly in heparin administration, monitoring, reversal and haemostasis, is known to differ significantly. To better characterize this variability, we conducted a Europe-wide survey..

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Comparison between regional citrate anticoagulation and systemic heparin anticoagulation in patients undergoing continuous renal replacement therapy and venoarterial extracorporeal membrane…

Abstract Introduction Regional citrate anticoagulation (RCA) is the recommended first-line strategy for continuous renal replacement therapy (CRRT) circuits. Acute kidney injury is common in patients undergoing venoarterial extracorporeal membrane oxygenation..

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Smart Clot: An Automated Point-of-Care Flow Assay for Quantitative Whole-Blood Platelet, Fibrin, and Thrombus Kinetics

Abstract Hemostasis depends on the coordinated interaction between platelets, coagulation factors, endothelium, and shear forces. Current point-of-care (POC) assays evaluate isolated components of haemostasis or operate under nearly static conditions,..

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Association Between Systemic Anticoagulation and Outcomes in Patients With Acute Respiratory Distress Syndrome Receiving Venovenous Extracorporeal Membrane Oxygenation: Insights From…

Abstract Objective:  To evaluate whether systemic anticoagulation therapy affects the survival of adult patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) for acute respiratory distress syndrome (ARDS). Design:  Multicenter retrospective study...

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Anticoagulation Management of Patients with Antiphospholipid Syndrome Undergoing Cardiopulmonary Bypass in Cardiac Surgery: Challenges and Current Strategies

Abstract The antiphospholipid syndrome (APS) is a complex autoimmune disease that causes a state of hypercoagulability that can result in recurrent venous and arterial thromboses. APS may lead to cardiac..

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Correlation of anticoagulation assays with bleeding during extracorporeal membrane oxygenation at a tertiary pediatric hospital

Abstract Introduction Due to anticoagulation during Extracorporeal Membrane Oxygenation (ECMO), patients face a higher risk of bleeding. This study aimed to assess the correlation between anticoagulation assays and hemorrhage in..

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Mortality and complications in low-dose vs standard-dose unfractionated heparin anticoagulation for extracorporeal membrane oxygenation: a systematic review and meta-analysis

Abstract Background Controversies exist in anticoagulation practices in extracorporeal membrane oxygenation (ECMO). It is uncertain whether the intensity of anticoagulation affects ECMO outcomes. Objectives To conduct a meta-analysis to determine..

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Heparin: Over 100 Years of Anticoagulation

Abstract This chapter provides an overview of heparin, including discovery, structure, mechanism of action, and principal use for anticoagulation. For over 100 years, heparin has a central role in prophylaxis..

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Increasing Anticoagulation Intensity in the Oxygenator During Flow Reduction Trials in Venoarterial Extracorporeal Membrane Oxygenation

Abstract Anticoagulation is mandatory during venoarterial extracorporeal membrane oxygenation (V-A ECMO) flow reduction trials with very low blood flow. Anticoagulation in the ECMO circuit might be intensified with less effect..

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Anticoagulation and hemostasis in the extracorporeal membrane oxygenation patient

Abstract Purpose of review  To provide an updated overview of hemostatic disturbances and anticoagulation management during extracorporeal membrane oxygenation (ECMO), emphasizing the mechanisms underlying the dual risk of bleeding and..

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Anticoagulation-free strategy within the first 24 h of extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest patients: a retrospective cohort study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR), involving VA-ECMO during refractory cardiac arrest, has been linked to improved outcomes. While systemic anticoagulation is commonly used to prevent circuit thrombosis, bleeding and..

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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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