Coagulations Studies Do Not Correlate With Each Other or With Hematologic Complications During Pediatric Extracorporeal Membrane Oxygenation*

OBJECTIVES: Anticoagulation plays a key role in the management of children supported with extracorporeal membrane oxygenation. However, the ideal strategy for monitoring anticoagulation remains unclear. Our objective was to evaluate the utility of laboratory measures of anticoagulation in pediatric extracorporeal membrane oxygenation. DESIGN: Retrospective cohort study. SETTING: Quaternary care academic children’s hospital. PATIENTS: Children in a noncardiac PICU cannulated to extracorporeal membrane oxygenation in 2010—2016. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Demographic data, laboratory values, and heparin doses were extracted from the enterprise data warehouse. Primary diagnoses, indications for cannulation, hemorrhagic and thrombotic complications, and survival outcomes were abstracted from the local registry used for Extracorporeal Life Support Organization reporting. Statistical models accounting for repeated measures using generalized estimating equations were constructed to evaluate correlations between heparin doses and laboratory values; among laboratory values; and between heparin dose or laboratory values and clinical outcomes. One hundred thirty-three unique patients—78 neonates and 55 older patients—were included in the study. There was no significant association between antifactor Xa level, activated partial thromboplastin time, activated clotting time, or heparin dose with hemorrha...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Feature Articles Source Type: research

Related Links:

Publication date: Available online 10 October 2020Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): N.G. Shah, B.C. Wible, J.A. Paulisi, M. Zaki, P. Lamparello, A. Sista, M. Sadek, G.R. Jacobowitz, T.S. Maldonado
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
CONCLUSIONS: As the present study was the first investigation on the coagulation status in patients with AA, elevated D-dimer levels in alopecia areata may suggest a deficient coagulation in these patients that may contribute to an increase in the risk of thrombosis. Further studies are needed to evaluate this hypothesis using a larger sample size. PMID: 33034439 [PubMed - as supplied by publisher]
Source: Giornale Italiano di Dermatologia e Venereologia - Category: Dermatology Tags: G Ital Dermatol Venereol Source Type: research
Publication date: Available online 7 October 2020Source: European UrologyAuthor(s): Amit Bansal, Anant Kumar
Source: European Urology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 9 October 2020Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): Chen Huang, Wenwen Zhang, Huoqi Liang
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Publication date: Available online 8 October 2020Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): Heepeel Chang, Caron B. Rockman, Glenn R. Jacobowitz, Giancarlo Speranza, William S. Johnson, James M. Horowitz, Karan Garg, Thomas S. Maldonado, Mikel Sadek, Michael E. Barfield
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
We present the case of limb ischemia secondary to accidental intra-arterial buprenorphine/naloxone film injection successfully treated with sublingual nitroglycerin. A 39-year-old man with history of intravenous drug use presented sudden severe left hand pain since three days prior to evaluation. Pain was preceded by self-injection of dissolved buprenorphine/naloxone sublingual film onto the affected arm. An arteriogram suggested severe vasoconstriction in the absence of frank thrombosis. Patient was initially treated with continuous heparin infusion and nifedipine. Forty-eight hours later, due to poor response, sublingual...
Source: Puerto Rico Health Sciences Journal - Category: International Medicine & Public Health Tags: P R Health Sci J Source Type: research
AbstractAbstractCancer patients with acute coronary syndrome (ACS) have significantly greater mortality compared with non-cancer patients. This risk is partly directly attributable to the malignancy; however these patients are frequently undertreated with respect to guideline recommended treatments for ACS due to higher bleeding risks from anemia and thrombocytopenia. Due to exclusion from large clinical trials, there is a paucity of data regarding how to best treat these complex and high-risk patients.Purpose of ReviewTo review the literature and identify risk factors among cancer patients associated with poor outcomes, p...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
AbstractPurpose of reviewLow molecular weight heparin (LMWH) has been the standard of care for patients with cancer-associated thrombosis (CAT) for over 10  years; however, its adoption has been limited. The appearance of direct acting oral anticoagulants (DOACs) revolutionized the treatment of non-cancer venous thromboembolism (VTE) through their attractive fixed dose regimens; however, a lack of dedicated trial experience had relegated their positio n to off-label use in patients with cancer. The goal of this review is to review the evidence that has been generated over the last 3 years for factor Xa inhibitors...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of reviewAtrial fibrillation is the commonest sustained arrhythmia in rheumatic heart disease and is associated with significant morbidity and mortality. In this review, we discuss its epidemiology, natural course and management with special emphasis on recent developments in understanding and treatment of atrial fibrillation in rheumatic heart disease.Recent findingsUse of direct oral anticoagulants appears promising, especially in developing countries where regular coagulation monitoring is a challenge. Also, restoration and maintenance of sinus rhythm in rheumatic atrial fibrillation appear feasible and ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
ConclusionsThe non-cirrhotic livers from pediatric patients with metabolic liver disease can be used as domino donor grafts for selected pediatric patients with different metabolic liver disease. D-APOLT achieves ideal recipient outcomes and provides a strategy to expand donor source for children.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
More News: Academia | Children | Hematology | Hospitals | Laboratory Medicine | Pediatrics | Statistics | Study | Thrombosis