Tags Archives: unfractionated heparin

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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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Performance of Hemochron ACT-LR and ACT+ Test Cuvettes in Monitoring Low to Moderate Heparin Concentrations: An In Vitro Study

Abstract Objectives According to the manufacturer, the Hemochron ACT-LR cuvette is designated for heparin concentrations of 0 to 2.5 IU/mL, while the optimal concentration range for the ACT+ cartridge is..

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Factors associated with activated clotting time following heparin administration in pediatric cardiopulmonary bypass: A retrospective study

Abstract Introduction The recently recommended activated clotting time (ACT) to be maintained at the initiation of and during cardiopulmonary bypass (CPB) is ≥480 s. However, the post-unfractionated heparin (UFH) administration ACT..

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Troubleshooting heparin resistance

Abstract The term heparin resistance is likely best defined as the failure of an appropriate dose of unfractionated heparin (UFH) to achieve a predetermined level of anticoagulation. Unfortunately, and despite..

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Unfractionated heparin monitoring by anti-factor Xa versus activated partial thromboplastin time strategies during venoarterial extracorporeal life support

Abstract Introduction No clear guidelines exist for unfractionated heparin (UFH) monitoring in adult patients on veno-arterial extracorporeal life support (VA-ECLS) for refractory cardiogenic shock. In this study, we sought to..

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Evaluating the Use of Unfractionated Heparin with Intra-Aortic Balloon Counterpulsation

Abstract Background Evidence supporting  with unfractionated heparin (UFH) in patients with an intra-aortic balloon pump (IABP) to prevent  remains limited, while bleeding risks remain high. Monitoring heparin in this setting with anti-factor..

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HEMA-Lysine-Based Cryogels for Highly Selective Heparin Neutralization

Abstract Unfractionated heparin (UFH) and its low-molecular-weight fragments (LMWH) are widely used as anticoagulants for surgical procedures and extracorporeal blood purification therapies such as cardiovascular surgery and dialysis. The anticoagulant..

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Pleiotropic Effects of Heparin and its Monitoring in the Clinical Practice

Abstract Unfractionated heparin (UFH) was uncovered in 1916, has been used as an anticoagulant since 1935, and has been listed in the World Health Organization's Model List of Essential Medicines...

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Factors Affecting the Discrepancy Between Coagulation Times on Extracorporeal Circulation Using Unfractionated Heparin in Children and Young Adults

Abstract In unfractionated heparin (UFH) monitoring during extracorporeal circulation, the traditional measures of activated clotting time (ACT) or activated partial thromboplastin time (APTT) may diverge, confounding anticoagulant adjustments. We aimed..

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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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Andexanet Alfa Neutralizes the Anticoagulant Effects of Unfractionated Heparin of Bovine, Ovine and Porcine Origin Almost as Protamine Sulfate

Abstract Introduction Andexanet alfa (AA) - zhzo, recombinant coagulation factor Xa, is an approved antidote for oral Xa inhibitors (apixaban and rivaroxaban). Unfractionated heparin (UFH) is commonly used for therapeutic,..

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Factors Influencing Anti-Xa Assays: A Multicenter Prospective Study in Critically Ill and Noncritically Ill Patients Receiving Unfractionated Heparin

Abstract Background The presence of dextran sulfate (DS) in reagents and the type of blood collection tube (citrate/citrated-theophylline-adenosine-dipyridamole [CTAD]) can lead to discrepancies between unfractionated heparin (UFH) anti-Xa levels. Objectives ..

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Factors Influencing Unfractionated Heparin Pharmacokinetics and Pharmacodynamics During a Cardiopulmonary Bypass

Abstract Background Unfractionated heparin (UFH) is commonly used during cardiac surgery with a cardiopulmonary bypass to prevent blood clotting. However, empirical administration of UFH leads to variable responses. Pharmacokinetic and..

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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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Resistance to unfractionated heparin in the ICU: evaluation and management options

Abstract Because of its rapid onset and offset of action, and its ability to be fully and rapidly reversed with protamine when anticoagulation control is needed, unfractionated heparin (UFH) remains..

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Predicting Therapeutic Response to Unfractionated Heparin Therapy: Machine Learning Approach

Abstract Background: Unfractionated heparin (UFH) is an anticoagulant drug that is considered a high-risk medication because an excessive dose can cause bleeding, whereas an insufficient dose can lead to a..

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Bivalirudin vs. heparin in paediatric and adult patients on extracorporeal membrane oxygenation: A meta-analysis

Abstract Aims Unfractionated heparin (UFH) has been the primary anticoagulant of choice on extracorporeal membrane oxygenation (ECMO). However, it is debatable whether bivalirudin (BIV), a direct thrombin inhibitor, may be..

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Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted Temperature Management Post Cardiac Arrest

Abstract Purpose: To evaluate unfractionated heparin (UFH) dosing guided by antifactor Xa levels during targeted temperature management (TTM) post-cardiac arrest. Methods: Single-center, retrospective, observational study between January 1, 2014 and..

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Activated Clotting Times Demonstrate Weak Correlation With Heparin Dosing in Adult Extracorporeal Membrane Oxygenation

Abstract Background:  The optimal monitoring strategy for anticoagulation management in extracorporeal membrane oxygenation (ECMO) remains a clinical controversy. The Extracorporeal Life Support Organization Anticoagulation Guidelines suggest that multiple anticoagulation assays..

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How to best monitor bivalirudin anticoagulant effect for ECMO and VAD—Comparison of four assay methods

Abstract Introduction Unfractionated heparin is widely used as an anticoagulant for extracorporeal life support (ECLS) and usually monitored with activated partial thromboplastin time (aPTT). Due to its limitations in pediatric..

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Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation: Heparin Versus Bivalirudin

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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Pharmacokinetic model of unfractionated heparin during and after cardiopulmonary bypass in cardiac surgery

Abstract Background: Unfractionated heparin (UFH) is widely used as a reversible anti-coagulant in cardiopulmonary bypass (CPB). However, the pharmacokinetic characteristics of UFH in CPB surgeries remain unknown because of the..

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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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