Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO.

ABSTRACT: During extracorporeal membrane oxygenation (ECMO), a delicate balance is required to titrate systemic anticoagulation to prevent thrombotic complications within the circuit and prevent bleeding in the patient. Despite focused efforts to achieve this balance, the frequency of both thrombotic and bleeding events remains high. Anticoagulation is complicated to manage in this population due to the complexities of the hemostatic system that are compounded by age-related developmental hemostatic changes, variable effects of the etiology of critical illness on hemostasis, and blood-circuit interaction. Lack of high-quality data to guide anticoagulation management in ECMO patients results in marked practice variability among centers. One aspect of anticoagulation therapy that is particularly chall

SUBMITTER: Chlebowski MM 

PROVIDER: S-EPMC6971875 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature