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Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children
Journal article   Open access   Peer reviewed

Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children

Madhuradhar Chegondi, Niranjan Vijayakumar and Balagangadhar R. Totapally
Pediatric reports, Vol.14(3), pp.320-332
09/01/2022
DOI: 10.3390/pediatric14030039
PMCID: PMC9326610
PMID: 35894028
url
https://doi.org/10.3390/pediatric14030039View
Published (Version of record) Open Access

Abstract

Extracorporeal Membrane Oxygenation (ECMO) is often used in critically ill children with severe cardiopulmonary failure. Worldwide, about 3600 children are supported by ECMO each year, with an increase of 10% in cases per year. Although anticoagulation is necessary to prevent circuit thrombosis during ECMO support, bleeding and thrombosis are associated with significantly increased mortality risk. In addition, maintaining balanced hemostasis is a challenging task during ECMO support. While heparin is a standard anticoagulation therapy in ECMO, recently, newer anticoagulant agents are also in use. Currently, there is a wide variation in anticoagulation management and diagnostic monitoring in children receiving ECMO. This review intends to describe the pathophysiology of coagulation during ECMO support, review of literature on current and newer anticoagulant agents, and outline various diagnostic tests used for anticoagulation monitoring. We will also discuss knowledge gaps and future areas of research.
Life Sciences & Biomedicine Pediatrics Science & Technology

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