Anticoagulation during ECMO in neonatal and paediatric patients

Rebecca Barton; Vera Ignjatovic; Paul Monagle

doi:10.1016/j.thromres.2018.05.009

Anticoagulation during ECMO in neonatal and paediatric patients

Thromb Res. 2019 Jan:173:172-177. doi: 10.1016/j.thromres.2018.05.009. Epub 2018 May 8.

Authors

Rebecca Barton¹, Vera Ignjatovic², Paul Monagle³

Affiliations

¹ Clinical Haematology, Royal Children's Hospital, Australia; Murdoch Children's Research Institute, Australia; Department of Paediatrics, The University of Melbourne, Australia.
² Murdoch Children's Research Institute, Australia; Department of Paediatrics, The University of Melbourne, Australia.
³ Clinical Haematology, Royal Children's Hospital, Australia; Murdoch Children's Research Institute, Australia; Department of Paediatrics, The University of Melbourne, Australia. Electronic address: paul.monagle@rch.org.au.

PMID: 29779622
DOI: 10.1016/j.thromres.2018.05.009

Abstract

Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor.

Keywords: Anticoagulation; Extracorporeal Membrane Oxygenation (ECMO); Haemorrhage; Paediatrics; Thrombosis.

Publication types

Review

MeSH terms

Anticoagulants / adverse effects
Anticoagulants / therapeutic use*
Blood Coagulation Tests / methods
Child
Drug Monitoring / methods
Extracorporeal Membrane Oxygenation / adverse effects
Extracorporeal Membrane Oxygenation / methods*
Hemorrhage / chemically induced
Hemostasis / drug effects
Humans
Infant
Thrombosis / prevention & control*

Substances

Anticoagulants