Anticoagulation and transfusion practices for neonatal and pediatric ECMO continue to vary widely across US centers, though there is a notable shift toward using anti-factor Xa assays for heparin monitoring.
Compared with the 2013 pediatric population, extracorporeal membrane oxygenation center anticoagulation and blood transfusion approaches continue to vary widely. Most report continued use of heparin as their primary anticoagulant and follow a combination of monitoring assays with the majority using the antifactor Xa assay in their practices, a significant shift from prior results. Antithrombin activity levels and viscoelastic tests are followed by a growing number of centers. Platelet transfusion thresholds continue to vary widely. Future research is needed to establish optimal anticoagulation and blood transfusion management.
Ozment et al. (Mon,) studied this question.