The Annals of thoracic surgery
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Heparin is the main anticoagulant used during extracorporeal membrane oxygenation (ECMO) support. Nafamostat mesilate, a synthetic serine protease inhibitor, has seen increased use as a substitute for heparin in patients undergoing ECMO because of its short half-life. We aimed to compare these 2 anticoagulants with respect to bleeding and thromboembolic complications during ECMO support. ⋯ Nafamostat mesilate was found to increase the bleeding risk in patients receiving venoarterial ECMO. Regarding thromboembolic complications, there was no significant difference between heparin and nafamostat. Only old age increased the thromboembolic risk.
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Multicenter Study
Effects of Blood Transfusion on Cause-Specific Late Mortality After Coronary Artery Bypass Grafting-Less Is More.
Red blood cell transfusion after coronary artery bypass graft surgery has been associated with increased late all-cause death. Yet, whether this association is, first, independent of the packed red blood cells and perioperative morbidity association, and second, of a cardiac versus noncardiac etiology remains unknown. ⋯ Perioperative red blood cells transfusion is associated with significant adverse late death effects among both complicated patients and noncomplicated patients, principally seen between 0 and 5 years postoperatively, and is driven by both increased cardiovascular and noncardiovascular mortality. Further studies are needed to elucidate the mechanisms behind these findings, including their potential dose dependence.