{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:18:38Z","timestamp":1793146718041,"version":"4.5.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["Ricerca Corrente - Linea di Ricerca ISMETT n 3"],"award-info":[{"award-number":["Ricerca Corrente - Linea di Ricerca ISMETT n 3"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation (VV ECMO) has a strong pathophysiological rationale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-center, retrospective cohort study of adult VV ECMO patients with anticoagulation maintained by UFH targeting an activated partial thromboplastin time (aPTT) of 40\u201350\u00a0s and AT activity &gt;80%. We compare anticoagulation management and survival outcomes between AT subpopulations, defined by a threshold AT activity \u226580%. Linear and logistic regression analyses were used to evaluate the variation in AT activity and its association with ICU survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 244 patients enrolled from 2009 to 2022, anticoagulation was maintained by a median heparin dose of 11.4\u00a0IU\/kg\/h [IQR: 8.2\u201314.7] with a mean aPTT of 46.1\u00a0s (\u00b17.3) and AT activity of 88.9% (\u00b117.0). A lower mean aPTT, higher dose of UFH and shorter fraction of time without UFH were associated with higher AT activity (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .01). Higher AT activity showed a consistent association with ICU survival (for 10% increase of AT, odds ratio for ICU mortality: 0.95; 95% CI 0.93\u20130.97;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      value &lt;.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a positive association between AT activity and UFH requirements but no significant difference in the rate of bleeding events. A higher mean AT during VV ECMO was associated with ICU survival. Future studies are needed to differentiate between exogenously supplemented versus endogenous AT effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591241258048","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:40:06Z","timestamp":1717501206000},"page":"720-729","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9190-4829","authenticated-orcid":false,"given":"Bethany A","family":"Hileman","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-2414","authenticated-orcid":false,"given":"Gennaro","family":"Martucci","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Rizzitello","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Occhipinti","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Tuzzolino","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-2045","authenticated-orcid":false,"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Maastricht University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Panigada","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda - Ospedale Maggiore Policlinico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"University of Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Arcadipane","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Panarello","sequence":"additional","affiliation":[{"name":"Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1089253209347384"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1039\/d3tb00471f"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.09.119"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-08-0687"},{"key":"e_1_3_5_6_2","volume-title":"ELSO guidelines for cardiopulmonary extracorporeal life support","author":"Extracorporeal Life Support Organization","year":"2017","unstructured":"Extracorporeal Life Support Organization. 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