Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference*

Figures

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  Figure 1.. Clinical guidance for the anticoagulation management of children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE). Weak recommendations (WRs), consensus statement with weak agreement (CS-W), consensus statement with strong agreement (defined as > 95%), and good practice statements (GPSs) are presented. CPB = cardiopulmonary bypass, DTI = direct thrombin inhibitor, HIT = heparin-induced thrombocytopenia, UFH = unfractionated heparin.

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  Figure 2.. Clinical guidance for the transfusion, coagulation factor, and antifibrinolytic management of children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE). Weak recommendations (WRs), consensus statements with weak agreement (CS-W), consensus statements with strong agreement (CS-S, defined as > 95%), and good practice statements (GPSs) are presented. CPB = cardiopulmonary bypass, INR = international normalized ratio, PCC = prothrombin complex concentrate, THA = topical hemostatic agents, UFH = unfractionated heparin, VWF = von Willebrand factor.

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  Figure 3.. General clinical guidance for the anticoagulation and transfusion management of children with bleeding or thrombotic complications on extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE). Weak recommendations (WRs), consensus statement with weak agreement (CS-W), consensus statement with strong agreement (CS-S, defined as > 95%), and good practice statements (GPSs) are presented. DIC = disseminated intravascular coagulopathy, GI = gastrointestinal, ICH = intracranial hemorrhage, INR = international normalized ratio, PCC = prothrombin complex concentrate.

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  Figure 4.. Organ-specific clinical guidance for the anticoagulation and transfusion management of children with bleeding or thrombotic complications on extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE). Weak recommendations (WRs), consensus statement with weak agreement (CS-W), consensus statement with strong agreement (CS-S, defined as > 95%), and good practice statements (GPSs) are presented. DIC = disseminated intravascular coagulopathy, ICH = intracranial hemorrhage, LA = left atrial, US = ultrasound, VA = venoarterial.

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  Figure 5.. Anticoagulation and transfusion algorithm example for children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE). *Clinically significant bleeding is defined as meeting any of the criteria listed for moderate or severe bleeding according to published definitions (4, 7, 8). aPTT = activated partial thromboplastin time, Hb = hemoglobin, INR = international normalized ratio, VA = venoarterial, VV = venovenous.