Current and future strategies to monitor and manage coagulation in ECMO patients

Fig. 1. Schematic of ECMO setup indicating the most likely clot formation sites

Fig. 2. Various anticoagulants used in ECMO devices and their monitoring methods (AT: Antithrombin; DTI: Direct Thrombin Inhibitor; DOAC: Direct Oral Anticoagulant; NM: Nafamostat mesylate; FBC: Full Blood Count; aPTT: Partial Thromboplastin Time; PT/INR: Prothrombin time/international normalized ratio; ECT: Ecarin Clotting Time; POC: Point-of-Care; ACT: Activated Clotting Time; ROTEM: Rotational Thromboelastometry; TEG: Thromboelastography)

Fig. 3. Acoustic spectrum of an infant patient in ECMO, the upper-left and lower-left spectra exhibit the inlet and outlet of a pump associated with an infant patient, respectively, while the upper-right and lower-right spectra depict the inflow and outflow spectrum, respectively, after 5 days for the same patient. Reused with permission from Ref. [127]

Fig. 4. a Illumination of the bottom surface of the pump by using stroboscope; Using the stroboscope method, it is feasible to view high-speed rotation of the impeller c which is not achievable without the use of the stroboscope method b Reused with permission from Ref. [130]

Fig. 5. Fluorescent images of adherent platelets on VWF, collagen, and fibrinogen of the blood samples at baseline and three hours after circulation in the two circuits. Modified and reused with permission from Ref. [132]

Fig. 6. Experimental results illustration: a Porcine blood with coagulation, b Porcine blood without coagulation. Reused with permission from Ref. [134]