{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:48:09Z","timestamp":1782078489826,"version":"3.54.5"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Standard anticoagulation protocols for patients with trauma-related acute respiratory distress syndrome (TR-ARDS) undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO) are often inapplicable due to high bleeding risks. This study evaluated the safety and feasibility of a prolonged anticoagulation-free strategy (\u226572\u00a0h) in patients with severe trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 37 patients with blunt TR-ARDS at a Level 1 Trauma Center (2016\u20132024). Patients were categorized into an anticoagulation-free group (withheld \u226572\u00a0h;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 18) and an anticoagulation group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Clinical outcomes, including survival (66.7% vs 68.4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 1.000), VV-ECMO weaning, and hemorrhagic\/thrombotic complications, were comparable between groups. Notably, the anticoagulation-free group exhibited significantly higher baseline severity, with lower Glasgow Coma Scale and Trauma and Injury Severity Score scores and more pronounced initial coagulopathy (prolonged PT, lower fibrinogen levels). Despite this, 12 of 18 patients (66.7%) in the anticoagulation-free group successfully completed their entire VV-ECMO course without any systemic anticoagulation, with no increase in circuit-related complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that withholding systemic anticoagulation for \u226572\u00a0h is a safe and feasible strategy for high-bleeding-risk trauma patients. This risk-adapted approach, prioritizing hemorrhage control, does not compromise patient safety or device integrity in selected patients with severe trauma and TR-ARDS. Larger multicenter prospective studies should validate this risk-stratified management framework.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261462278","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:59:22Z","timestamp":1781719162000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of prolonged anticoagulation-free venovenous ECMO management beyond 72 hours in post-traumatic ARDS: A single-center retrospective cohort study"],"prefix":"10.1177","author":[{"given":"Changsung","family":"Han","sequence":"first","affiliation":[{"name":"Pusan National University School of Medicine, Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunghwan","family":"Song","sequence":"additional","affiliation":[{"name":"Pusan National University School of Medicine, Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soojin","family":"Lee","sequence":"additional","affiliation":[{"name":"Pusan National University School of Medicine, Biomedical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na Hyeon","family":"Lee","sequence":"additional","affiliation":[{"name":"National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019070"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.02.020"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sipas.2022.100071"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591221093880"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001216"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03348-w"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.04.54"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002242"},{"key":"e_1_3_5_10_2","first-page":"497","article-title":"Heparin-free veno-venous ECMO applied to a patient with severe lung contusion and hypovolemic shock due to trauma","volume":"24","author":"Moon SH","year":"2018","unstructured":"Moon SH, Kim KN, Jung JJ, et al. Heparin-free veno-venous ECMO applied to a patient with severe lung contusion and hypovolemic shock due to trauma. Ulus Travma Acil Cerrahi Derg 2018; 24: 497\u2013500. https:\/\/doi.org\/10.5505\/tjtes.2018.33802","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001276"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-14741-6"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06593-x"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001230"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249854"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261462278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261462278","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261462278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:21:27Z","timestamp":1782076887000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261462278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":14,"alternative-id":["10.1177\/02676591261462278"],"URL":"https:\/\/doi.org\/10.1177\/02676591261462278","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"article-number":"02676591261462278"}}