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Original Article

Pulmonary
The role of nafamostat mesilate as a regional anticoagulant during extracorporeal membrane oxygenation: Jae Ha Lee, Jin Han Park, Ji Hoon Jang, Se Hun Kim, Sung Yong Hong, Woon Heo, Dong-Hwan Lee, Hye Sook Choi, Ki Hoon Kim, Hang-Jea Jang; Acute Crit Care. 2022;37(2):177-184. Published online April 20, 2022; DOI: https://doi.org/10.4266/acc.2021.01312

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316 Download
19 Web of Science
19 Crossref

Abstract PDF

Background
Anticoagulation during extracorporeal membrane oxygenation (ECMO) usually is required to prevent thrombosis. The aim of this study was to investigate the usefulness of nafamostat mesilate (NM) as a regional anticoagulant during veno-arterial ECMO (VA-ECMO) treatment.
Methods
We retrospectively reviewed the medical records of 16 patients receiving VA-ECMO and NM from January 2017 to June 2020 at Haeundae Paik Hospital. We compared clinical and laboratory data, including activated partial thromboplastin time (aPTT), which was measured simultaneously in patients and the ECMO site, to estimate the efficacy of regional anticoagulation.
Results
The median patient age was 68.5 years, and 56.3% of patients were men. Cardiovascular disease was the most common primary disease (75.0%) requiring ECMO treatment, followed by respiratory disease (12.5%). The median duration of ECMO treatment was 7.5 days. Among 16 patients, seven were switched to NM after first using heparin as an anticoagulation agent, and nine received only NM. When comparing aPTT values in the NM group between patients and the ECMO site, that in patients was significantly lower than that at the ECMO site (73.57 vs. 79.25 seconds; P=0.010); in contrast, no difference was observed in the heparin group.
Conclusions
NM showed efficacy as a regional anticoagulation method by sustaining a lower aPTT value compared to that measured at the ECMO site. NM should be considered as a safer regional anticoagulation method in VA-ECMO for patients at high risk of bleeding.

Citations

Citations to this article as recorded by

Alternate and Emerging Anticoagulation Strategies for Extracorporeal Membrane Oxygenation: A Scoping Review
Akshay Kumar, Nicole Carlo, Rithish Nimmagadda, Juber Dastagir Shaikh, Sourabh Khatri, Vivek Varghese
Journal of Clinical Medicine.2026; 15(6): 2337. CrossRef
Catheter diameter and infection control are important in neonatal continuous kidney replacement therapy: a single-center retrospective study
Hiroki Otsuka, Masaya Kibe, Chie Ishihara, Takuya Tokuhisa
Renal Replacement Therapy.2025;[Epub] CrossRef
Anticoagulation with Nafamostat Mesilate During Impella Support: A Case Report
Makiko Nakamura, Teruhiko Imamura, Yuki Hida, Toshihide Izumida, Masaki Nakagaito, Saori Nagura, Toshio Doi, Koichiro Kinugawa
Medicina.2025; 61(2): 309. CrossRef
Comparison of regional citrate anticoagulation and nafamostat mesylate anticoagulation during plasma exchange for children at high bleeding risk: a retrospective study
Dan Peng, Zili Cai, Jie He, Wei Duan, Xinping Zhang
Italian Journal of Pediatrics.2025;[Epub] CrossRef
Pharmacokinetic and pharmacodynamic analyses of nafamostat in ECMO patients: comparing central vein and ECMO machine samples
Dong Hwan Lee, Jae Ha Lee, Ji Hoon Jang, Yong Kyun Kim, Gaeun Kang, So Young Jung, Minyoung Her, Hang Jea Jang
Frontiers in Pharmacology.2025;[Epub] CrossRef
Comparison of different anticoagulation methods in continuous renal replacement therapy for pediatric acute liver failure patients: a retrospective observational study
Jie He, Xinping Zhang
Frontiers in Pediatrics.2025;[Epub] CrossRef
Development of a predictive model for nafamostat mesylate dosing in hemodialysis
Shin Yeong Lee, Jin Sug Kim, Hwa Jeong Kim, Jeong Min Yoon, Moon Jeong Seo, Ji Yung Lee, Kyung-A Choi, Kyun Sang Lee, Ah Ran Choi, Sung Min Ko, Kyoung Hwa Seo, Hae Rim Kim
BMC Nephrology.2025;[Epub] CrossRef
Value of nafamostat mesylate in venoarterial extracorporeal membrane oxygenation anticoagulation—A retrospective cross‐sectional study
Jianhua Wu, Fujin Chen, Yujie Pan, Jincun Shi, Tong Su, Bukao Ni, Dechang Chen, Xiaobo Wang
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Scientific Reports.2025;[Epub] CrossRef
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Biomedicines.2025; 13(11): 2705. CrossRef
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Shameek Gayen, Stephen Dachert, Bilal Lashari, Matthew Gordon, Parag Desai, Gerard Criner, Juan Cardet, Kartik Shenoy
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Complications and Outcomes in 39,864 Patients Receiving Standard Care Plus Mechanical Circulatory Support or Standard Care Alone for Infarct-Associated Cardiogenic Shock
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Journal of Clinical Medicine.2024; 13(4): 1167. CrossRef
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Drugs.2024; 84(10): 1199. CrossRef
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Case Report

Liver/Infection
Chylous Ascites in a Patient with Sepsis Caused by Bilateral Pneumonia: Yong Dae Lee, Young Hyun Lee, Hye Sook Choi; Korean J Crit Care Med. 2014;29(3):217-221. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.217

20,348 View
103 Download
2 Crossref

Abstract PDF

Chylous ascites is a rare form of ascites characterized by milky peritoneal fluid rich in triglycerides due to the accumulation of chyle in the peritoneal cavity. This affliction occurs as a result of a disruption of lymph flow associated with traumatic injury or obstruction of the lymphatic system. There are various causes of chylous ascites, such as lymphatic anomalies, malignancy, cirrhosis, infection, trauma, surgery, and nephrotic syndrome. We report a rare case of an 81-year-old male with sepsis caused by bilateral pneumonia who presented with chylous ascites.

Citations

Citations to this article as recorded by

Disorders of Lymphatic Architecture and Flow in Critical Illness
Maxim Itkin, Jiri Horak, Jose L. Pascual, Cherylee W. J. Chang, Deacon Lile, Beverly Tomita, Gary Alan Bass, Stephen J. Kovach, Lewis J. Kaplan
Critical Care Medicine.2025; 53(3): e665. CrossRef
Diagnostic and management problems of chylous effusion in a patient with newly-diagnosed tuberculosis
Dicky Febrianto, Usman Hadi
Current Internal Medicine Research and Practice Surabaya Journal.2021; 2(2): 35. CrossRef

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