World J Crit Care Med
Department of Anesthesia, Mayo Clinic, Rochester, MN 55905, United States.
Published: October 2019
Use of extracorporeal membrane oxygenation to support patients with critical cardiorespiratory illness is increasing. Systemic anticoagulation is an essential element in the care of extracorporeal membrane oxygenation patients. While unfractionated heparin is the most commonly used agent, unfractionated heparin is associated with several unique complications that can be catastrophic in critically ill patients, including heparin-induced thrombocytopenia and acquired antithrombin deficiency. These complications can result in thrombotic events and subtherapeutic anticoagulation. Direct thrombin inhibitors (DTIs) are emerging as alternative anticoagulants in patients supported by extracorporeal membrane oxygenation. Increasing evidence supports DTIs use as safe and effective in extracorporeal membrane oxygenation patients with and without heparin-induced thrombocytopenia. This review outlines the pharmacology, dosing strategies and available protocols, monitoring parameters, and special use considerations for all available DTIs in extracorporeal membrane oxygenation patients. The advantages and disadvantages of DTIs in extracorporeal membrane oxygenation relative to unfractionated heparin will be described.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854393 | PMC |
http://dx.doi.org/10.5492/wjccm.v8.i6.87 | DOI Listing |
Eur J Heart Fail
January 2025
Department for Internal Medicine and Cardiology, Technische Universität Dresden, Heart Centre Dresden, University Hospital, Dresden, Germany.
Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).
Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.
Transl Pediatr
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Division of Cardiac Surgery, Department of Surgery, Dentistry, Pediatrics and Gynecology, Verona, Italy.
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View Article and Find Full Text PDFMed Klin Intensivmed Notfmed
January 2025
Interdisziplinäre Medizinische Intensivtherapie (IMIT), Universitätsklinikum Freiburg, Hugstetterstraße 55, 79106, Freiburg, Deutschland.
Port J Card Thorac Vasc Surg
October 2024
Intensive Care Medicine, Centro Hospitalar e Universitário São João, Porto, Portugal; Faculty of Medicine, Porto University, Portugal.
Background And Objectives: The optimal management of high-risk and intermediate-high-risk Pulmonary Embolism (PE) is a matter of ongoing debate. This paper aims to assess the short and long-term clinical outcomes associated with different treatment approaches for high-risk and intermediate-high-risk PE within an Intensive Care Unit (ICU) and identify potential areas for improvement.
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BMC Pediatr
January 2025
Division of Neonatology, Pediatric Intensive Care & Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Background: Lung ultrasound scoring is a validated tool for assessing lung pathology. However, existing scoring systems typically overlook the size of consolidations, limiting their accuracy in certain clinical scenarios.
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