Tags Archives: Anticoagulation

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Bivalirudin anticoagulation for left ventricular assist device implantation on an extracorporeal life support system in patients with heparin-induced thrombocytopenia antibodies

Abstract OBJECTIVES Heparin-induced thrombocytopenia (HIT) requires alternative anticoagulation strategies. We investigated outcomes in patients with HIT antibodies undergoing low-dose bivalirudin anticoagulation during left ventricular assist device implantation on an extracorporeal..

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Anesthetic Management of Patients on ECMO

Abstract The management of a patient placed on extracorporeal membrane oxygenation (ECMO) is a team effort. The anesthesiology team plays an integral part during cannulation and oftentimes as well during..

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ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

Abstract The interaction between the patient and the ECMO (extracorporeal membrane oxygenation) circuit initiates a significant coagulation and inflammatory response due to the large surface area of foreign material contained..

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Veno-arterial extracorporeal membrane oxygenation without therapeutic anticoagulation for intra-operative cardiopulmonary support during lung transplantation

Abstract Cardiopulmonary support is frequently required during lung transplantation. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been recently shown to be an acceptable and, perhaps, safer alternative to cardiopulmonary bypass machine..

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Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation

Abstract Objectives:  Extracorporeal membrane oxygenation is a life-sustaining therapy for severe respiratory failure. Extracorporeal membrane oxygenation circuits require systemic anticoagulation that creates a delicate balance between circuit-related thrombosis and bleeding-related..

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Anticoagulation and Transfusions Management in Veno-Venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: Assessment of Factors Associated With Transfusion…

Abstract Purpose: We describe an approach for anticoagulation and transfusions in veno-venous–extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. Methods: Observational study..

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Citrate pathophysiology and metabolism

Abstract By chelating ionized  allows  circuit  without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of  and platelets. Citrate clearance by  (Krebs cycle) is not modified by renal..

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The Munich Lung Transplant Group: Intraoperative Extracorporeal Circulation in Lung Transplantation

Abstract Background This retrospective single-center study aimed to analyze transfusion requirements, coagulation parameters, and outcome parameters in patients undergoing lung transplantation (LuTx) with intraoperative extracorporeal circulatory support, comparing cardiopulmonary bypass..

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Heparin Resistance Is Common in Patients Undergoing Extracorporeal Membrane Oxygenation but Is Not Associated with Worse Clinical Outcomes

Abstract Extracorporeal membrane oxygenation (ECMO) protocols generally require systemic anticoagulation with heparin to prevent circuit thrombosis. The prevalence, risk factors, and outcomes of heparin resistance in this setting are ill-defined. To better..

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Thromboelastometry, Thromboelastography, and Conventional Tests to Assess Anticoagulation During Extracorporeal Support: A Prospective Observational Study

Abstract Optimal anticoagulation monitoring in patients with extracorporeal membrane oxygenation (ECMO) is fundamental to avoid hemorrhagic and thromboembolic complications. Besides conventional coagulation tests, there is growing interest in the use..

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Blood Conservation in Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome

Abstract Background  support (ECMO) typically requires multiple  and is associated with frequent bleeding complications. Blood transfusions are known to increase morbidity and mortality in critically ill patients, which may extend to..

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Developments in Pediatric Ventricular Assist Device Support

Abstract Mechanical support devices have revolutionized the management of circulatory failure. This has been met by a dramatic increase in ventricular assist device (VAD) utilization in children over the last..

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Anticoagulation during ECMO in neonatal and paediatric patients

Abstract  (ECMO) is a form of  (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and . Management of ECMO requires..

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Evaluation of Systemic Heparin Versus Bivalirudin in Adult Patients Supported by Extracorporeal Membrane Oxygenation

Abstract Systemic anticoagulation is a standard of care in adult patients supported by extracorporeal membrane oxygenation (ECMO) to prevent circuit thrombosis and subsequent thromboembolic events. Unfractionated heparin has long been..

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Assessment of Heparin Anticoagulation Measured Using i-STAT and Hemochron Activated Clotting Time

Objective Adequate , measured using  (ACT), is important during vascular and cardiac surgeries. Unfractionated heparin is the most common  used. The purpose of this analysis was to compare the i-STAT ACT (iACT) to..

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Anticoagulation with VADs and ECMO: walking the tightrope

Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac..

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Surgical Technique Influences HeartMate II Left Ventricular Assist Device Thrombosis

Background  of the HeartMate II (HM2 [Thoratec Corporation, Pleasanton, CA]) is a potentially devastating complication. While attention has been focused on  strategies to prevent this complication, the impact of surgical technique..

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A New Anticoagulation Strategy Using Recombinant Human Thrombomodulin in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Study

Abstract Background During veno-venous extracorporeal membrane oxygenation (VV-ECMO), systemic anticoagulation is required to prevent thrombotic complications within the circuit and oxygenator. The unfractionated heparin (UFH) is commonly administered as a..

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Anticoagulation Management and Antithrombin Supplementation Practice during Veno-venous Extracorporeal Membrane Oxygenation: A Worldwide Survey

Background There is a lack of consensus on how to manage anticoagulation during veno-venous extracorporeal membrane oxygenation, including antithrombin monitoring and supplementation. The authors’ aim was to determine current practice..

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COVID-19 and ECMO: An Unhappy Marriage of Endothelial Dysfunction and Hemostatic Derangements

Severe respiratory syndrome coronavirus-2 is responsible for coronavirus disease 2019 (COVID-19), which may lead to acute respiratory failure. In its most severe manifestation including refractory hypoxemia and/or hypercapnia, it can..

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Measures of Anticoagulation and Coagulopathy in Pediatric Cardiac Extracorporeal Membrane Oxygenation Patients

Abstract Introduction: Pediatric cardiac Extracorporeal Membrane Oxygenation (ECMO) is effective, however, bleeding and clotting issues continue to cause significant morbidity and mortality. The objective of this study was to assess..

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Anticoagulation Management in Severe Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation

Abstract Objective To explore special coagulation characteristics and anticoagulation management in extracorporeal membrane oxygenation (ECMO)–assisted patients with coronavirus disease 2019 (COVID-19). Design Single-center, retrospective observation of a series of patients...

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