Anticoagulation in the ICU: Contact Pathway Inhibition Future

Anticoagulation in the ICU: Contact Pathway Inhibition Future

Bleeding and thrombotic complications are the main cause of morbidity and mortality in critically ill patients on the intensive care unit (ICU), receiving short-term percutaneous mechanical circulatory support (pMCS) by extracorporeal... read more

Heterogeneous Treatment Effects of Therapeutic-Dose Heparin in Patients Hospitalized for COVID-19

Heterogeneous Treatment Effects of Therapeutic-Dose Heparin in Patients Hospitalized for COVID-19

Randomized clinical trials (RCTs) of therapeutic-dose heparin in patients hospitalized with COVID-19 produced conflicting results, possibly due to heterogeneity of treatment effect (HTE) across individuals. Better understanding... read more

Heparin-based vs. Bivalirudin-based Anticoagulation in Pediatric ECMO

Heparin-based vs. Bivalirudin-based Anticoagulation in Pediatric ECMO

Bivalirudin may be a safe, cost-effective alternative to heparin in achieving anticoagulation in pediatric extracorporeal membrane oxygenation (ECMO) patients. Prospective multicenter studies and randomized control trials... read more

Ascending Aortic Thrombus After COVID-19 Infection

Ascending Aortic Thrombus After COVID-19 Infection

SARS-CoV-2 predisposes patients to both venous and arterial thromboembolism, including ascending aortic thrombus. The current guidelines for anticoagulation recommend three to six months of continuous anticoagulation... read more

Bivalirudin vs. Heparin for Maintenance Systemic Anticoagulation During ECMO

Bivalirudin vs. Heparin for Maintenance Systemic Anticoagulation During ECMO

When compared with heparin-based systemic anticoagulation, bivalirudin demonstrated feasibility and safety as established by the absence of increases in identifiable adverse outcomes while manifesting substantial improvements... read more

Effectiveness of Therapeutic Heparin vs. Prophylactic Heparin on COVID-19 Patients

Effectiveness of Therapeutic Heparin vs. Prophylactic Heparin on COVID-19 Patients

In moderately ill patients with covid-19 and increased D-dimer levels admitted to hospital wards, therapeutic heparin was not significantly associated with a reduction in the primary outcome but the odds of death at 28 days... read more

Venous Thromboembolism Prophylaxis in Critically Ill Adults

Venous Thromboembolism Prophylaxis in Critically Ill Adults

Among critically ill adults, compared to control, low molecular weight heparin (LMWH) reduces incidence of deep venous thrombosis (DVT) while UFH and mechanical compressive devices may reduce risk of DVT. LMWH is probably... read more

Therapeutic Anticoagulation vs. Usual Care in Noncritically Ill COVID-19 Patients

Therapeutic Anticoagulation vs. Usual Care in Noncritically Ill COVID-19 Patients

Among noncritically ill patients with COVID-19 infection, therapeutic anticoagulation with heparin improved the proportion of patients who survived without need for organ support. Therapeutic anticoagulation was associated... read more

Use of Bivalirudin for Anticoagulation in Pediatric ECMO

Use of Bivalirudin for Anticoagulation in Pediatric ECMO

This study describes the use of bivalirudin in children on extracorporeal membrane oxygenation (ECMO). Pediatric patients receiving bivalirudin were compared to patients receiving heparin as the anticoagulant on ECMO. Data... read more

Tox and Hound – Metal Hydrides

Tox and Hound – Metal Hydrides

We are left with four main scenarios in which arsine gas is produced and/or encountered: aqueous solutions of oxidized arsenic compounds in contact with metals metal arsenides in contact with water/moisture release... read more

Troponin Elevation in Non-cardiac Critical Illness

Troponin Elevation in Non-cardiac Critical Illness

This article is about how to approach ischemia evaluation for the "non-cardiac" critically ill patient (someone admitted for a problem such as sepsis, stroke, or DKA). This is tough. We want to be thorough enough not to miss... read more

Early Hemostatic Management of Disseminated Intravascular Coagulopathy

Early Hemostatic Management of Disseminated Intravascular Coagulopathy

Inflammation and coagulation pathobiology play a significant role in the development of multiorgan failure occurring with sepsis. Inflammation induced by an infection can lead to endothelial injury, which subsequently... read more

Accuracy of Heparin-Binding Protein in Diagnosing Sepsis

Accuracy of Heparin-Binding Protein in Diagnosing Sepsis

The diagnostic ability of heparin-binding protein is favorable, demonstrating both high sensitivity and specificity in predicting progression to sepsis in critically ill patients. Future studies could assess the incremental... read more

Massive PE with Intra-hospital Cardiac Arrest and Full Recovery of RV Function after vaECMO

Massive PE with Intra-hospital Cardiac Arrest and Full Recovery of RV Function after vaECMO

The concept of vaECMO treatment alone might be a valuable alternative in selected patients with massive PE and cardiogenic shock, in whom thrombolytic therapy might not unload the RV fast enough. We present a case of a... read more