Adult Critical Care Medicine

Adult Critical Care Medicine

This clinical casebook provides a comprehensive yet concise state-of-the-art review of adult critical care medicine. Presented in a case-based format, each case focuses on a scenario commonly encountered with an adult patient... read more

Tailoring Antithrombotic Treatment in Patients with Acute Myocardial Infarction and Cancer

For more than two decades, dual platelet antiplatelet therapy (DAPT) has been one of the mainstays in the treatment of patients who have suffered an acute myocardial infarction (AMI) or undergoing percutaneous coronary intervention... read more

Platelets and Fibrinogen Matter When Bleeding on ECMO

Platelets and Fibrinogen Matter When Bleeding on ECMO

Fibrinolysis is poorly investigated in ECMO patients, partly due to a lack of routine laboratory tests evaluating fibrinolysis. Hence, hyperfibrinolysis may be a contributor to bleeding risk during ECMO treatment. However,... read more

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

A Case of Chronic Mesenteric Ischemia Due to Celiac and Mesenteric Artery Thrombosis

A Case of Chronic Mesenteric Ischemia Due to Celiac and Mesenteric Artery Thrombosis

Chronic mesenteric ischemia (CMI) is uncommon and accounts for approximately 5% of cases. CMI presents with non-specific symptoms, making it difficult to diagnose, and requires complex management involving interprofessional... read more

Prostacyclin Anticoagulation Efficacy in Critically Ill Patients Requiring Extracorporeal Support

Prostacyclin Anticoagulation Efficacy in Critically Ill Patients Requiring Extracorporeal Support

Extracorporeal support modalities are highly prothrombotic. Anticoagulation is frequently used for patients receiving Continuous Renal Replacement Therapy (CRRT), Molecular Adsorbent Recirculating System (MARS), and Extracorporeal... read more

Disseminated Intravascular Coagulation in COVID-19 Setting

Disseminated Intravascular Coagulation in COVID-19 Setting

Disseminated intravascular coagulation (DIC) is an acquired syndrome that can lead to catastrophic thrombosis and hemorrhage. In DIC, an uncontrolled release of pro-inflammatory mediators activates tissue factor-dependent... read more

Thrombotic and Bleeding Complications During Antithrombotic Treatment

Thrombotic and Bleeding Complications During Antithrombotic Treatment

Remarkable progress has been made in the pharmacological management of patients with cardiovascular disease, including the frequent use of antithrombotic agents. Nonetheless, bleeding complications remain frequent and potentially... read more

Atrial Fibrillation and Ischemic Stroke Patients While on Oral Anticoagulation

Atrial Fibrillation and Ischemic Stroke Patients While on Oral Anticoagulation

Patients with Atrial Fibrillation (AF) and ischemic stroke while on oral anticoagulation are at increased risk of recurrent ischemic stroke and death. These patients currently have an unmet medical need. Individual participant... read more

No Benefits For Using 4-Factor Prothrombin Complex Concentrate (4F-PCC) in Trauma Patients

No Benefits For Using 4-Factor Prothrombin Complex Concentrate (4F-PCC) in Trauma Patients

Early administration of 4-factor prothrombin complex concentrate (4F-PCC) was of no benefit to patients with trauma at risk of massive transfusion, the randomized PROCOAG trial from France showed. Among over 300 patients... read more

PLASMIC Score Role in the Management of Thrombotic Thrombocytopenic Purpura

PLASMIC Score Role in the Management of Thrombotic Thrombocytopenic Purpura

At centers that are resource-limited and where ADAMTS-13 testing is not readily available, it is imminent that treatment is started immediately based on the clinical presentation and PLASMIC score. A PLASMIC score can... read more

Increased Risk of Hospitalization in Celiac Disease with COVID-19 Infection Is Mitigated by Vaccination

Increased Risk of Hospitalization in Celiac Disease with COVID-19 Infection Is Mitigated by Vaccination

Celiac disease (CD) patients with COVID-19 have a higher risk of hospitalization compared with non-CD referents. This risk is mitigated by vaccination in CD patients as it is in non-CD referents. ICU requirement occurred... read more

Algorithm to Predict Thromboembolism in COVID-19 Patients

Algorithm to Predict Thromboembolism in COVID-19 Patients

Patients with COVID-19 are at increased risk for thrombosis and might be stratified on admission based on lower Pao2/FiO2 ratio, higher D-dimer levels and history of major hemorrhages. 64 thromboses were recorded in 54... read more

Trauma-induced Coagulopathy

Trauma-induced Coagulopathy

Trauma is a major cause of mortality worldwide, and bleeding is the leading preventable cause of death. About one-quarter of patients with severe trauma develop a clotting disorder termed trauma-induced coagulopathy (TIC)... read more

Perioperative Management of Antithrombotic Therapy

Perioperative Management of Antithrombotic Therapy

Substantial new evidence has emerged since the 2012 iteration of these guidelines, especially to inform best practices for the perioperative management of patients who are receiving a VKA and may require heparin bridging,... read more

Bleeding and Thrombotic Events in Patients with Severe COVID‑19 on ECMO

Bleeding and Thrombotic Events in Patients with Severe COVID‑19 on ECMO

In a nationwide cohort of COVID‑19 patients supported by extracorporeal membrane oxygenation (ECMO), bleeding incidence was high and associated with mortality. Intracranial hemorrhage incidence was higher than reported... read more

Tranexamic Acid in Gastrointestinal Bleeding

Tranexamic Acid in Gastrointestinal Bleeding

Extended-use high-dose IV tranexamic acid does not improve mortality or bleeding outcomes and increases adverse events. Low-dose/enteral tranexamic acid may be effective in reducing hemorrhage; more evidence is required to... read more