Tags Archives: hemostasis

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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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Assessing the Efficacy of Pathogen-Reduced Platelet Transfusions for Hemostasis in Children Undergoing Cardiopulmonary Bypass Surgery

Abstract Background Children undergoing cardiopulmonary bypass (CPB) surgery are vulnerable to bleeding and often require transfusions. Pathogen-reduced (PR) platelets may reduce microbial contamination but are associated with decreased platelet count..

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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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ECMO produces very rapid changes in primary hemostasis detected by PFA-200 during lung transplantation: An observational study

Abstract Background The pathology of primary hemostasis is a common complication of extracorporeal membrane oxygenation (ECMO) support. Scientific data describing its changes in patients on short-term ECMO support and the..

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Can machine learning provide preoperative predictions of biological hemostasis after extracorporeal circulation for cardiac surgery?

Abstract Objectives The goal of this study was to improve decision making regarding the transfusion of patients at the end of extracorporeal circulation for cardiac surgery through machine learning predictions..

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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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Correlations between the Circulating Level of Cell-Derived Microparticles and Surgical Variables in Heart Valve Surgery with Cardiopulmonary Bypass

Abstract Background: Cell-derived microparticles (MPs) as membrane vesicles are procoagulant. They play a role in surgical hemostasis. In this study, the correlations between the circulating level of cell-derived MPs and..

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In Vitro Treatment of Extracorporeal Membrane Oxygenation Coagulopathy with Recombinant von Willebrand Factor or Lyophilized Platelets

Abstract Objectives The objective was to compare primary  between adult ECMO patients and cardiac surgical patients before  and . Furthermore, the authors explored whether in vitro treatment of ECMO patient blood samples with  (vWF)..

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In vitro comparison of spatiotemporal fibrin clot formation dynamics in plasma treated with different protamine-heparin ratios

Abstract Introduction Our study aim was to explore how different protamine-heparin ratios impacted enzymatic coagulation and acellular fibrin clot growth in plasma using an in vitro model. We hypothesized that..

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Consensus Statement: Hemostasis Trial Outcomes in Cardiac Surgery and Mechanical Support

Abstract Background Research evaluating hemostatic agents for the treatment of clinically significant bleeding has been hampered by inconsistency and lack of standardized primary clinical trial outcomes. Clinical trials of hemostatic..

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Efficacy, Safety, and Strategies for Recombinant-Activated Factor VII in Cardiac Surgical Bleeding: A Narrative Review

Abstract As perioperative bleeding continues to be a major source of morbidity and mortality in cardiac surgery, the search continues for an ideal  for use in this patient population. Transfusion of..

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Optimizing Perioperative Blood and Coagulation Management During Cardiac Surgery

Abstract Major blood loss remains common in cardiac surgery with an incidence of up to 15%. Bleeding leads to anemia and blood product transfusion, and can lead to the need..

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A Randomized Pilot Trial Assessing the Role of Human Fibrinogen Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants…

Abstract The objective of this study was to determine whether treatment with human fibrinogen concentrate decreases the need for component blood therapy and blood loss in neonate and infant patients..

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Aptamer-based factor IXa inhibition preserves hemostasis and prevents thrombosis in a piglet model of ECMO

Abstract Extracorporeal membrane oxygenation (ECMO) requires anticoagulation to prevent clotting when the patient’s blood contacts the circuit. Unfractionated heparin (UFH) usually prevents clotting but can cause life-threatening bleeding. An anticoagulant..

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Agreement Between the TEG 6s and TEG 5000 Analyzers in Extracorporeal Membrane Oxygenation

Abstract Thromboelastography (TEG) evaluates viscoelastic properties of blood clot formation. The TEG 5000 analyzer is commonly used but prone to errors related to vibration or operator error. The TEG 6s..

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Prothrombin complex concentrates in cardiac surgery: where are we?

Abstract Purpose of review  Major bleeding in cardiac surgery is commonly encountered, and, until recently, most frequently managed with fresh frozen plasma (FFP). However, a Cochrane review found this practice..

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The association of thrombin generation with bleeding outcomes in cardiac surgery: a prospective observational study

Abstract Background Cardiac surgery with cardiopulmonary bypass (CPB) is associated with coagulopathic bleeding. Impaired thrombin generation may be an important cause of coagulopathic bleeding but is poorly measured by existing..

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Factor XI Inhibition to Uncouple Thrombosis From Hemostasis: JACC Review Topic of the Week

Abstract Hemostasis and thrombosis are believed to be so intricately linked that any strategies that reduce thrombosis will have an inevitable impact on hemostasis. Consequently, bleeding is viewed as an unavoidable..

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Recombinant Factor VIIa in pediatric cardiac surgery

Abstract Objectives Recombinant factor VIIa is used off-label for refractory bleeding after cardiac surgery. This study reviewed the indications, usage rates and complications of recombinant factor VIIa. Design Retrospective case..

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The use of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) in neonates: a systematic review

Abstract “Developmental hemostasis” refers to the dynamic process of gradual hemostatic maturation. Conventional coagulation tests seem to fail to accurately depict the in vivo hemostasis, while viscoelastic tests, thromboelastography (TEG),..

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Altered Fibrinolysis during and after Surgery

Abstract Major surgery induces hemostatic changes related to surgical stress, tissue destruction, and inflammatory reactions. These changes involve a shift of volume from extravascular space to intravascular and interstitial spaces,..

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Novel Anticoagulants. Hemostasis Post Cardiopulmonary Bypass - Part 1

Joe Basha, CCP lectures and discusses novel anticoagulants and how they may create challenges to hemostasis post cardiopulmonary bypass.   

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Haem is associated with thrombosis in neonates and infants undergoing cardiac surgery for congenital heart disease

Abstract Background Haem levels are associated with thrombosis in a variety of diseases, as well as being a contributing cause of thrombotic events in animal models. Materials and Methods We..

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Acute Kidney Injury in Cardiac Surgery and Cardiac Intensive Care

Abstract Acute kidney injury (AKI) is a serious postoperative complication following cardiac surgery. Despite the incidence of AKI requiring temporary renal replacement therapy being low, it is nonetheless associated with..

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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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Heparin–protamine balance after neonatal cardiopulmonary bypass surgery

Abstract Essentials   Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..

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Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

Abstract OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have..

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Heparin–protamine balance after neonatal cardiopulmonary bypass surgery

Abstract Essentials   Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..

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Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

Abstract OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have..

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Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer’s chase technique – a…

Abstract Introduction: Residual pump blood from the cardiopulmonary bypass (CPB) circuit is often collected into an infusion bag (IB) and re-transfused. An alternative is to chase the residual blood into..

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