Critical Care Update: Cardiology

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: 28 February 2026 | Viewed by 346

Special Issue Editors

Special Issue Information

Dear Colleagues,

The outstanding development of critical care in recent decades has led to improved patient outcomes and reduced mortality. The multidisciplinary care of critically ill patients is an integral part of every modern healthcare system, ensuring improved outcomes, which are guaranteed by the prompt development of diverse diagnostic and therapeutic modalities and supported by the continuous education of health workers. Faster and easier access to care, the early recognition of life-threatening medical conditions and complications, and organized emergency care all contribute to treatment strategy for patients with cardiac pathology. Furthermore, the fast development of technologies and continuous research in the field of critical care in modern cariology requires the wide dissemination of information to clinicians. This Special Issue on “Critical Care Update: Cardiology” welcomes the submission of work on the most recent developments and challenges in diagnosis and therapy related to advances in experimental and clinical cardiology, surgery, anesthesia, and intensive care research and practice, addressing innovative therapeutic and diagnostic strategies in the care of cardiac patients. We invite all researchers from relevant disciplines who focus on the care of critically ill patients to submit original articles or reviews in their area of expertise, enhancing the multidisciplinarity of modern healthcare.

Dr. Sasa Rajsic
Dr. Benedikt Treml
Guest Editors

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Keywords

  • critical care
  • cardiology
  • resuscitation
  • PCA
  • myocardial infarct
  • acute illness
  • intensive care
  • shock
  • cardiogenic shock
  • ECMO
  • arrhythmias
  • STEMI

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Published Papers (1 paper)

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13 pages, 450 KiB  
Systematic Review
Activated Clotting Time and Haemostatic Complications in Patients Receiving ECMO Support: A Systematic Review
by Daniel Schwaiger, Lukas Schausberger, Benedikt Treml, Dragana Jadzic, Nicole Innerhofer, Christoph Oberleitner, Zoran Bukumirić, Igor Spurnić and Sasa Rajsic
J. Cardiovasc. Dev. Dis. 2025, 12(7), 267; https://doi.org/10.3390/jcdd12070267 - 13 Jul 2025
Viewed by 268
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to prevent clotting, typically using unfractionated heparin (UFH). However, anticoagulation carries a bleeding risk, necessitating monitoring. Activated clotting time (ACT) is a commonly used monitoring tool for UFH anticoagulation. However, systematized evidence linking ACT [...] Read more.
Background: Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to prevent clotting, typically using unfractionated heparin (UFH). However, anticoagulation carries a bleeding risk, necessitating monitoring. Activated clotting time (ACT) is a commonly used monitoring tool for UFH anticoagulation. However, systematized evidence linking ACT monitoring with haemostatic complications (bleeding and thrombosis) is missing. Methods: A systematic review (Scopus and PubMed, up to 13 July 2024) including studies reporting on the patients receiving ECMO support with UFH anticoagulation monitored using ACT was performed. Results: A total of 3536 publications were identified, of which 30 (2379 patients) were included in the final review. Thirteen studies found no significant association between ACT values and haemorrhage, while four studies suggested a relationship between elevated ACT levels and bleeding events. Eight studies demonstrated no association between ACT values and the occurrence of thrombosis. Major bleeding was most common (49%, 13 studies with 501 events), while the pooled rate of thrombosis was 25% (16 studies with 309 events) and in-hospital mortality was 51% (17 studies, 693/1390 patients). Conclusions: Despite advancements in ECMO, the optimal approach for anticoagulation monitoring remains undefined. Most studies in this review did not establish a significant relationship between ACT levels and haemostatic complications. Based on the current evidence, ACT does not appear to be a reliable tool for monitoring anticoagulation in patients receiving ECMO, and alternative methods should be considered. Full article
(This article belongs to the Special Issue Critical Care Update: Cardiology)
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