New Advances in Extracorporeal Life Support (ECLS)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: 18 June 2025 | Viewed by 1843

Special Issue Editors


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Guest Editor
Clinic of Emergency Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
Interests: extracorporeal life support; cardiac anesthesia; heart failure; anesthesia for minimally invasive cardiac surgery

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Guest Editor
Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
Interests: cardiogenic shock; assisted circulation; ventricular assist device; aortic stenosis; transcatheter aortic valve implanta-tion; echocardiography
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Guest Editor
Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
Interests: acute myocardial infarction; cardiogenic shock; interventional cardiology; structural heart disease; cardiac imaging
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Special Issue Information

Dear Colleagues,

The use of extracorporeal life support (ECLS) is expanding worldwide. As of now, more than 200.000 patients have been reported to the ELSO registry. Indeed, it is successfully being used to support patients with severe respiratory failure, cardiogenic shock, and during cardiopulmonary resuscitation, as well as for organ procurement from donations after circulatory death. Moreover, ECLS is increasingly being used to support high-risk patients during cardiac procedures in a cathlab, patients with drug poisoning and cases of severe septic shock. It is also being used for trauma patients, such as severe combat casualties in war zones. However, the duration of supporting patients and the age of the patients themselves are going beyond the boundaries of ECMO care. For instance, patients are being transported under ECMO support for thousands of kilometers. In addition, ECLS is still associated with frequent complications and high patient mortality. New technological advances and new applications of this support mode, alongside research and academic collaboration, might lead to better outcomes for our patients. This Special Issue of the Journal of Clinical Medicine is dedicated to new advances in extracorporeal life support.

Prof. Dr. Robertas Stasys Samalavičius
Prof. Dr. Pranas Šerpytis
Prof. Dr. Holger Thiele
Guest Editors

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Keywords

  • extracorporeal life support (ECLS)
  • extracorporeal membrane oxygenation (ECMO)
  • innovations in ECLS
  • respiratory failure
  • cardiogenic shock
  • eCPR

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Published Papers (1 paper)

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Review

24 pages, 650 KiB  
Review
Heparin Resistance in Patients Receiving Extracorporeal Membrane Oxygenation: A Review
by Tatyana Li, Azhar Zhailauova, Aidyn Kuanyshbek, Iwan Wachruschew, Shaimurat Tulegenov, Vitaliy Sazonov and Timur Kapyshev
J. Clin. Med. 2024, 13(24), 7633; https://doi.org/10.3390/jcm13247633 - 14 Dec 2024
Viewed by 1360
Abstract
Heparin resistance (HR) in patients on extracorporeal membrane oxygenation (ECMO) exacerbates bleeding and thrombogenesis. Thus far, there is no universal definition of what this condition entails and no unified strategy for assessing heparin’s efficacy in ECMO patients. The most frequent discrepancy when it [...] Read more.
Heparin resistance (HR) in patients on extracorporeal membrane oxygenation (ECMO) exacerbates bleeding and thrombogenesis. Thus far, there is no universal definition of what this condition entails and no unified strategy for assessing heparin’s efficacy in ECMO patients. The most frequent discrepancy when it comes to defining HR is the difference in the reported doses: units per day (U/d) or per kilogram per hour (U/kg/h). Another disagreement arises with regard to the various methods of measuring unfractionated heparin (UFH) efficacy. Due to numerous processes that begin with ECMO initiation, including protein layer formation on the surface of circuits, the recruitment of immune cells, the activation of complement and contact activation systems, and platelets, assessing pure antithrombin consumption is complicated. Moreover, there is an alternative anticoagulation procedure performed by a serine protease inhibitor named heparin cofactor II, which could also contribute to heparin consumption. Considering simultaneously launched processes of inflammation and thrombogenesis in response to contact with artificial surfaces on ECMO, we listed the possible mechanisms contributing to additional antithrombin consumption. The effect of the flow on the platelets’ activation and von Willebrand factor (vWF) assembly was also described. We reviewed the scientific literature from PubMed and Embase to identify possible definitions of heparin resistance during ECMO treatment among pediatric and adult cohorts. We identified 13 records describing different approaches to assessing HR and described our vision of delineating HR on ECMO. Full article
(This article belongs to the Special Issue New Advances in Extracorporeal Life Support (ECLS))
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