Tags Archives: Bleeding

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Monitoring Hemostatic Function during Cardiac Surgery with Point-of-Care Viscoelastic Assays: A Narrative Review

Abstract Bleeding is a well-known and severe complication of cardiac surgery. Cardiopulmonary bypass, along with heparinization and hemodilution, is thought to affect all pathways of the hemostatic process, leading to..

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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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Cardiac Surgical Bleeding, Transfusion, and Quality Metrics: Joint Consensus Statement by the Enhanced Recovery After Surgery Cardiac Society and Society…

Abstract Background Excessive perioperative bleeding is associated with major complications in cardiac surgery, resulting in increased morbidity, mortality, and cost. Methods An international expert panel was convened to develop consensus..

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Platelet-sparing properties of aprotinin

Abstract BACKGROUND  Cardiac surgery involving cardiopulmonary bypass (CPB) is associated with the risk of acquired coagulopathy, including dysregulated fibrinolysis, which can result in life-threatening bleeding complications. Aprotinin, an antifibrinolytic agent,..

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Major Bleeding and Mortality After Revascularization of Left Main Disease

Abstract Background The incidence and prognostic impact of major bleeding (MB) after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) are..

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Evaluation of Red Blood Cell Biochemical Markers and Coagulation Profiles Following Cell Salvage in Cardiac Surgery: A Systematic Review and…

Abstract Background: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell..

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Postoperative bleeding outcome of fresh frozen plasma prime in pediatric cardiac surgery: A systematic review & meta-analysis

Abstract Introduction Bleeding after cardiac surgeries holds risk of mortality and morbidity in pediatrics. This systematic review aimed to evaluate postoperative blood loss and blood transfusion requirements for pediatric patients..

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Urgent Reversal of Direct Oral Anticoagulants in Critical and Life-Threatening Bleeding: A Multidisciplinary Expert Consensus

Abstract Direct oral anticoagulants (DOACs) are increasingly being used due to their improved efficacy/safety ratio and lower clinical and economic burden when compared to vitamin K antagonists. However, bleeding is..

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Comparable bleeding and inflammation outcomes between heparin-coated and uncoated minimal invasive extracorporeal circuits in isolated coronary artery bypass surgery –…

Abstract Objective Minimally invasive extracorporeal circulation has been shown to be non-inferior or even superior to conventional cardiopulmonary bypass circuits in isolated coronary artery bypass grafting, but there is little..

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Impact of intraoperative blood products, fluid administration, and persistent hypothermia on bleeding leading to reexploration after cardiac surgery

Abstract Objective Risk factors for severe postoperative bleeding after cardiac surgery remain multiple and incompletely elucidated. We evaluated the impact of intraoperative blood product transfusions, intravenous fluid administration, and persistently..

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A dimensional analysis of experienced intensive care unit nurses' clinical decision-making for bleeding after cardiac surgery

Abstract Bleeding following cardiac surgery is common and serious, yet a gap persists in understanding how experienced intensive care nurses identify and respond to such complications. Aim To describe the..

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POBS-Card, a new score of severe bleeding after cardiac surgery: Construction and external validation

Abstract Objective Bleeding after cardiac surgery leads to poor outcomes. The objective of the study was to build the PeriOperative Bleeding Score in Cardiac surgery (POBS-Card) to predict bleeding after..

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Non-invasive prediction of massive transfusion during surgery using intraoperative hemodynamic monitoring data

Abstract Objective Failure to receive prompt  leads to severe complications if massive  occurs during surgery. For the timely preparation of blood products, predicting the possibility of massive transfusion (MT) is essential to..

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Delayed cold-stored vs. room temperature stored platelet transfusions in bleeding adult cardiac surgery patients—a randomized multicentre pilot study (PLTS-1)

Abstract Background Platelets stored at 1–6 °C are hypothesized to be more hemostatically active than standard room temperature platelets (RTP) stored at 20–24 °C. Recent studies suggest converting RTP to cold-stored platelets..

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Consumptive coagulopathy: how low-dose unfractionated heparin can prevent bleeding complications during extracorporeal life support

Abstract Bleeding and thrombotic complications are major drivers in extracorporeal life support (ECLS) patients’ negative outcomes and are reported in up to 40% of the ECLS-runs [1, 2]. Consumptive coagulopathy..

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European practices on antithrombotic management during percutaneous mechanical circulatory support in adults: A survey of the Association for Acute CardioVascular…

Abstract Background Bleeding and thrombotic complications compromise outcomes in patients undergoing percutaneous mechanical circulatory support (pMCS) with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and/or microaxial flow pumps like the Impella™...

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An architecturally rational hemostat for rapid stopping of massive bleeding on anticoagulation therapy

Abstract Hemostatic devices are critical for managing emergent severe bleeding. With the increased use of anticoagulant therapy, there is a need for next-generation hemostats. We rationalized that a hemostat with..

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Recombinant Activated Factor VII (rFVIIa) for Bleeding After Thoracic Aortic Surgery: A Scoping Review of Current Literature

Abstract Background Bleeding after surgery on the thoracic aorta is a frequent complication, and can be associated with a significant increase in morbidity and mortality. Recombinant activated factor VII (rFVIIa)..

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Cold-stored platelets for acute bleeding in cardiac surgical patients: a narrative review

Abstract Purpose Cold-stored platelets (CSP) are an increasingly active topic of international research. They are maintained at 1–6 °C, in contrast to standard room-temperature platelets (RTP) kept at 20–24 °C. Recent evidence..

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Using Machine Learning to Predict Bleeding after Cardiac Surgery

Abstract OBJECTIVES The primary objective was to predict bleeding after cardiac surgery with machine learning using the data from the ANZSCTS (Australia New Zealand Society of Cardiac and Thoracic Surgeons)..

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Platelets and fibrinogen matter when bleeding on ECMO

Abstract We have read with interest the work by Helms et al., a single-center study with 30 patients (16 on veno-venous and 14 on veno-arterial extracorporeal membrane oxy-genation (ECMO)), with..

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Simple Tool for Bleeding Control During Minimally Invasive and Robotic Cardiac Surgery

Abstract Achievement of complete hemostasis is a key element to success in cardiac surgery. Bleeding control is of utmost importance in minimally invasive and robotic cardiac surgery to avoid conversion,..

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Influence of Fibrinogen Concentrate on Neonatal Clot Structure When Administered Ex Vivo After Cardiopulmonary Bypass

Abstract BACKGROUND: Bleeding is a serious complication of cardiopulmonary bypass (CPB) in neonates. Blood product transfusions are often needed to adequately restore hemostasis, but are associated with significant risks. Thus,..

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Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Abstract Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia..

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Bleeding patients on extracorporeal membrane oxygenation have reduced platelet aggregation and plasma fibrinogen: a longitudinal observational study

Abstract This study investigated changes in coagulation and associations with occurrence of bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy. The study included 100 adult ECMO-patients. Standard coagulation parameters,..

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Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Abstract BACKGROUND  Management of peri-operative bleeding is complex and involves multiple assessment tools and strategies to ensure optimal patient care with the goal of reducing morbidity and mortality. These updated..

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Procoagulant platelets: novel players in thromboinflammation

Abstract Platelets play a key role in maintaining hemostasis. However, dysregulated platelet activation can lead to pathological thrombosis or bleeding. Once a platelet gets activated, it will either become an..

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Hypothermic circulatory arrest does not induce coagulopathy in vitro

Abstract Hypothermic circulatory arrest (HCA) is an essential procedure during aortic surgery to protect organs; however, hypothermia is believed to cause coagulopathy, which is a major fatal complication. This study..

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Outcomes with Direct and Indirect Thrombin Inhibition during Extracorporeal Membrane Oxygenation for COVID-19

Abstract Anticoagulation during extracorporeal membrane oxygenation (ECMO) for Coronovirus Disease 2019 (COVID-19) can be performed by direct or indirect thrombin inhibitors but differences in outcomes with these agents are uncertain...

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Major Bleeding and Thromboembolic Events in Veno-Venous Extracorporeal Membrane Oxygenation-Patients With Isolated Respiratory Failure

Abstract Bleeding and thromboembolic events are common during veno-venous extracorporeal membrane oxygenation (vvECMO). It is unknown whether these complications are driven by the ECMO system itself, multiorgan-failure, or both. The..

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