Arvin Anticoagulation for Prolonged Extracorporeal Membrane Oxygenation

Büky, B; Bell, W. Blair; Matthews, P.; Reidy, Tobi; Jj, White

doi:10.1097/00002480-197301900-00011

Cited by 10 publications

(1 citation statement)

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“…For patients who do not respond well to inotropic drugs or IABP support, mechanical circulatory support should be used in order to reduce mortality rate. ECMO is one of the extracorporeal life support systems, and relative research started in the 1960s [42,43] . The application of ECMO for cardiogenic shock after cardiac surgery have emerged since 1980s [44] .…”

Section: Discussionmentioning

confidence: 99%

Extra-Corporeal Membrane Oxygenation (ECMO) for Postcardiotomy Cardiogenic Shock (PCCS) in Asian Patients: A Systematic Review and Meta-Analysis

Sun

et al. 2021

Preprint

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Background Extra-corporeal membrane oxygenation (ECMO) is an important extracorporeal life support system to treat patients with postcardiotomy cardiogenic shock (PCCS). But its effectiveness and safety are still inconclusive. Existing systematic reviews and meta-analysis have heterogeneity challenges such as the inclusion of different races in the same study.Objective The impact of ECMO treatment on the survival rate of Asian adult patients with PCCS was evaluated by searching the literature and using the method of systematic review and meta-analysis.Study Design and Methods PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, WANFANG MED ONLINE, SinoMed were searched to find relevant research on the use of ECMO on PCCS patients in Asia. Outcomes included survival rate to hospital discharge, long-term survival rate, complications.Results A total of 32 articles were selected, including observational studies and one RCT, involving China and Japan covering 4,278 PCCS patients. The pooled rate of survival to hospital discharge was 43.0% (95% CI 38% ~47%, I2 = 87%), the pooled 1-year, 2-year, and 3-year survival rate were 34% (95% CI 26% ~ 42%, I2 = 85%), 29% (95% CI 18% ~39%, I2 = 93%), 25% (95%CI 16% ~35%, I2=93%). The pooled rate of bleeding, neurologic complications, rethoracotomy, leg ischemia, renal failure, renal replacement therapy, and infection were 18% (95% CI 13% ~24%, I2=91%), 13% (95% CI 9% ~17%, I2 = 90.0%), 36% (95% CI 27% ~46%, I2 = 97.0%), 11% (95% CI 9% ~13%, I2 = 55%), 40% (95% CI 27% ~54%, I2 = 90%), 45% (95% CI 35% ~ 56%, I2 = 98%), 26% (95%CI (20%~31%, I2=95%).Conclusion ECMO can provide survival benefits for Asian adult patients with PCCS. However, attention should be paid to reducing the incidence of complications, especially renal failure. More high-quality clinical studies are needed to confirm the survival benefit of ECMO.

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Section: Discussionmentioning

confidence: 99%

Extra-Corporeal Membrane Oxygenation (ECMO) for Postcardiotomy Cardiogenic Shock (PCCS) in Asian Patients: A Systematic Review and Meta-Analysis

Sun

et al. 2021

Preprint

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Defibrinogenation as an alternative to heparinization in prolonged extracorporeal circulation

Roy

Guidoin

Martin³

et al. 1980

Res. Exp. Med.

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Complications arising from difficulty controlled bleeding and thrombus formation during procedures which require extracorporeal circulation with heparin as anticoagulant motivate the search for better hemostasis and anticoagulant technology. An enzyme (Defibrase), having a specific interaction with fibrinopeptide A such as to cause fibrin depletion in a soluble form, has been proposed as an alternative to heparin. Defibrase, in contrast to heparin, does not affect blood platelet function. Heparin and Defibrase as anticoagulants were compared in 8 h perfusion studies using arterio-venous extracorporeal blood circuits in dogs; the circuitry included pumps, membrane oxygenators and filters serially. Thrombus formation, in the filters and the oxygenators as well as pathology of the perfused animal were investigated. The results suggest that defibrase-like enzymes have potential for enhanced control of hemorrhagic and thrombotic phenomena. Although impeded by a latency of several hours before the full anticoagulant properties are developed in vivo, it appears that enzymatically mediated defibrinogenation of blood may be a valuable alternative to heparinization in extracorporeal circulation procedures.

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Defibrinogenation as an alternative to heparinization during prolonged extracorporeal circulation in the dog

Berglin

Teger‐Nilsson

et al. 1976

Thrombosis Research

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Arvin Anticoagulation for Prolonged Extracorporeal Membrane Oxygenation

Cited by 10 publications

References 0 publications

Extra-Corporeal Membrane Oxygenation (ECMO) for Postcardiotomy Cardiogenic Shock (PCCS) in Asian Patients: A Systematic Review and Meta-Analysis

Extra-Corporeal Membrane Oxygenation (ECMO) for Postcardiotomy Cardiogenic Shock (PCCS) in Asian Patients: A Systematic Review and Meta-Analysis

Defibrinogenation as an alternative to heparinization in prolonged extracorporeal circulation

Defibrinogenation as an alternative to heparinization during prolonged extracorporeal circulation in the dog

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