Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
4 "anticoagulation"
Filter
Filter
Article category
Keywords
Publication year
Authors
Original Articles
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
  • 4,178 View
  • 253 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract 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  
  • Management of cardiopulmonary bypass in patients with ischemic and hemorrhagic strokes in surgery for active infective endocarditis
    Takahiro Yamazato, Hiroshi Munakata, Yutaka Okita
    Indian Journal of Thoracic and Cardiovascular Surgery.2024; 40(S1): 61.     CrossRef
  • Approach to Decompensated Right Heart Failure in the Acute Setting
    Catherine V. Levitt, Caitlin A. Williams, Jalil Ahari, Ali Pourmand
    Journal of Clinical Medicine.2024; 13(3): 869.     CrossRef
  • Critical Care Management of Severe Asthma Exacerbations
    Shameek Gayen, Stephen Dachert, Bilal Lashari, Matthew Gordon, Parag Desai, Gerard Criner, Juan Cardet, Kartik Shenoy
    Journal of Clinical Medicine.2024; 13(3): 859.     CrossRef
  • Complications and Outcomes in 39,864 Patients Receiving Standard Care Plus Mechanical Circulatory Support or Standard Care Alone for Infarct-Associated Cardiogenic Shock
    Jan-Sören Padberg, Jannik Feld, Leonie Padberg, Jeanette Köppe, Lena Makowski, Joachim Gerß, Patrik Dröge, Thomas Ruhnke, Christian Günster, Stefan Andreas Lange, Holger Reinecke
    Journal of Clinical Medicine.2024; 13(4): 1167.     CrossRef
  • Extra-Corporeal Membrane Oxygenation in Pregnancy
    Tatsiana Romenskaya, Yaroslava Longhitano, Aman Mahajan, Gabriele Savioli, Antonio Voza, Manfredi Tesauro, Christian Zanza
    Journal of Clinical Medicine.2024; 13(6): 1634.     CrossRef
  • Anticoagulants in adult extracorporeal membrane oxygenation: alternatives to standardized anticoagulation with unfractionated heparin
    Shu Tang, Liqing Xu, Hui Li, Zhanshen Wu, Qiang Wen
    European Journal of Clinical Pharmacology.2023; 79(12): 1583.     CrossRef
Thoracic Surgery
Safety of Surgical Tracheostomy during Extracorporeal Membrane Oxygenation
Hye Ju Yeo, Seong Hoon Yoon, Seung Eun Lee, Doosoo Jeon, Yun Seong Kim, Woo Hyun Cho, Dohyung Kim
Korean J Crit Care Med. 2017;32(2):197-204.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00059
  • 8,793 View
  • 174 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO.
Methods
From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST.
Results
Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST.
Conclusions
The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.

Citations

Citations to this article as recorded by  
  • Tracheostomy in Critically Ill COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Single-Center Experience
    Phillip Staibano, Shahzaib Khattak, Faizan Amin, Paul T. Engels, Doron D. Sommer
    Annals of Otology, Rhinology & Laryngology.2023; 132(12): 1520.     CrossRef
  • Does Tracheostomy Improve Outcomes in Those Receiving Venovenous Extracorporeal Membrane Oxygenation?
    Joel C. Boudreaux, Marian Urban, Shaun L. Thompson, Anthony W. Castleberry, Michael J. Moulton, Aleem Siddique
    ASAIO Journal.2023; 69(6): e240.     CrossRef
  • Tracheostomy in high-risk patients on ECMO: A bedside hybrid dilational technique utilizing a Rummel tourniquet
    Britton B. Donato, Marisa Sewell, Megan Campany, Ga-ram Han, Taylor S. Orton, Marko Laitinen, Jacob Hammond, Xindi Chen, Jasmina Ingersoll, Ayan Sen, Jonathan D'Cunha
    Surgery Open Science.2023; 16: 248.     CrossRef
  • Assessing Clinical Feasibility and Safety of Percutaneous Dilatational Tracheostomy During Extracorporeal Membrane Oxygenation Support in the Intensive Care Unit
    Tae Hwa Hong, Hyung Won Kim, Hyoung Soo Kim, Sunghoon Park
    Journal of Acute Care Surgery.2022; 12(1): 18.     CrossRef
  • Retrospective analysis of open bedside tracheotomies in a German tertiary care university hospital
    Maximilian Riekert, Matthias Kreppel, Philipp Schminke, Annelies Weckx, Joachim E. Zöller, Volker C. Schick
    Journal of Cranio-Maxillofacial Surgery.2021; 49(2): 140.     CrossRef
  • Otolaryngology during COVID-19: Preventive care and precautionary measures
    Chen Zhao, Alonço Viana, Yan Wang, Hong-quan Wei, Ai-hui Yan, Robson Capasso
    American Journal of Otolaryngology.2020; 41(4): 102508.     CrossRef
  • Tracheostomy while on Extracorporeal Membrane Oxygenation: A Comparison of Percutaneous and Open Procedures
    Ismael A. Salas De Armas, Kha Dinh, Bindu Akkanti, Pushan Jani, Reshma Hussain, Lisa Janowiak, Kayla Kutilek, Manish K. Patel, Mehmet H. Akay, Rahat Hussain, Jayeshkumar Patel, Chandni Patel, Yafen Liang, John Zaki, Biswajit Kar, Igor D. Gregoric
    The Journal of ExtraCorporeal Technology.2020; 52(4): 266.     CrossRef
Case Reports
Vascular Surgery/Nephrology
Spontaneous Lumbar Artery Bleeding and Retroperitoneal Hematoma in a Patient Treated with Continuous Renal Replacement Therapy
Jin Kyung Park, Sung Ho Kim, Hee Jin Kim, Duk Hyun Lee
Korean J Crit Care Med. 2015;30(4):318-322.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.318
Correction in: Acute Crit Care 2016;31(1):71
  • 7,269 View
  • 88 Download
  • 2 Crossref
AbstractAbstract PDF
Rupture of the lumbar artery is usually associated with trauma but rarely has been reported in association with anticoagulation. We present a 71-year-old man who developed spontaneous rupture of the lumbar artery leading to a retroperitoneal hematoma while receiving continuous renal replacement therapy (CRRT). The bleeding was confirmed by computed tomography and angiography and was controlled successfully using selective angiographic embolization. We suggest that spontaneous retroperitoneal bleeding should be considered in a case of sudden decrease in hemoglobin in a CRRT patient.

Citations

Citations to this article as recorded by  
  • Transcatheter Arterial Embolization of Spontaneous Soft Tissue Hematomas: A Systematic Review
    Lahoud Touma, Sarah Cohen, Christophe Cassinotto, Caroline Reinhold, Alan Barkun, Vi Thuy Tran, Olivier Banon, David Valenti, Benoit Gallix, Anthony Dohan
    CardioVascular and Interventional Radiology.2019; 42(3): 335.     CrossRef
  • Three cases of spontaneous lumbar artery rupture in hemodialysis patients
    Na Kyoung Hwang, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Chang Won Kim, Sang Heon Song
    Hemodialysis International.2017;[Epub]     CrossRef
Hemothorax in an Uncontrolled Anticoagulated Patient: Fight or Flight?: A Case Report
Soon Ho Chon, Sung Ho Shinn, Chul Burm Lee
Korean J Crit Care Med. 2009;24(1):37-38.
DOI: https://doi.org/10.4266/kjccm.2009.24.1.37
  • 2,003 View
  • 15 Download
AbstractAbstract PDF
Hemothorax in a patient on anticoagulant therapy for atrial fibrillation after blunt trauma is not an uncommon event. However, massive hemothorax in such a patient with an extremely uncontrolled and high international normalized ratio (INR) may pose a serious dilemma. We report a case of a patient under anticoagulant therapy for atrial fibrillation who underwent an emergent thoracotomy for massive hemothorax with an INR of 9.57.

ACC : Acute and Critical Care