{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:52:21Z","timestamp":1784123541886,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T00:00:00Z","timestamp":1688860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010quality evidence for post\u2010cardiotomy extracorporeal life support (PC\u2010ECLS) management is lacking. This study investigated real\u2010world PC\u2010ECLS clinical practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional, multi\u2010institutional, international pilot survey explored center organization, anticoagulation management, left ventricular unloading, distal limb perfusion, PC\u2010ECLS monitoring, and transfusion practices. Twenty\u2010nine questions were distributed among 34 hospitals participating in the Post\u2010cardiotomy Extra\u2010Corporeal Life Support Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 32 centers [16 low\u2010volume (50%); 16 high\u2010volume (50%)] that responded, 16 (50%) had dedicated ECLS specialists. Twenty\u2010six centers (81.3%) reported using additional mechanical circulatory supports. Anticoagulation practices were highly heterogeneous: 24 hospitals (75%) reported using patients bleeding status as a guide, without a specific threshold in 54.2% of cases. Transfusion targets ranged from 7 to 10\u2009g\/dL. Most centers used cardiac venting on a case\u2010by\u2010case basis (78.1%) and regular distal limb perfusion (84.4%). Nineteen (54.9%) centers reported dedicated monitoring protocols, including daily echocardiography (87.5%), Swan\u2010Ganz catheterization (40.6%), cerebral near\u2010infrared spectroscopy (53.1%), and multimodal assessment of limb ischemia. Inspection of the circuit (71.9%), oxygenator pressure drop (68.8%), plasma free hemoglobin (75%), d\u2010dimer (59.4%), lactate dehydrogenase (56.3%), and fibrinogen (46.9%) are used to diagnose hemolysis and thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study shows remarkable heterogeneity in clinical practices for PC\u2010ECLS management. More standardized protocols and better implementation of the available evidence are recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14601","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T00:56:58Z","timestamp":1687654618000},"page":"1641-1653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Heterogeneity in clinical practices for post\u2010cardiotomy extracorporeal life support: A pilot survey from the <scp>PELS<\/scp>\u20101 multicenter study"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-1399","authenticated-orcid":false,"given":"Silvia","family":"Mariani","sequence":"first","affiliation":[{"name":"Cardio\u2010Thoracic Surgery Department Cardiovascular Research Institute Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-5736","authenticated-orcid":false,"given":"Gabor","family":"Bari","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic Surgery Department Cardiovascular Research Institute Maastricht  Maastricht The Netherlands"},{"name":"Department of Cardiac Surgery, Clinic of Internal Medicine University of Szeged  Szeged Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8716-1290","authenticated-orcid":false,"given":"Justine M.","family":"Ravaux","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic Surgery Department Cardiovascular Research Institute Maastricht  Maastricht The Netherlands"},{"name":"Department of Cardiac Surgery University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-7848","authenticated-orcid":false,"given":"Bas C. 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