This review highlights the complexities of systemic anticoagulation in pediatric ECMO patients and discusses relevant pathophysiology, anticoagulants, and monitoring tools.
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Highlights anticoagulation complexities in pediatric ECMO; leaves open optimal protocols pending prospective trials.
Extracorporeal membrane oxygenation (ECMO) is a salvage therapy for critically ill patients. Although ECMO is becoming more common, hemorrhagic and thromboembolic complications remain the major causes of death in patients undergoing ECMO treatments. These complications commence upon blood contact with artificial surfaces of the circuit, blood pump, and oxygenator system. Therefore, anticoagulation therapy is required in most cases to prevent these problems. Anticoagulation is more complicated in pediatric patients than in adults, and the foreign surface of ECMO only increases the complexity of systemic anticoagulation. In this review, we discuss the pathophysiology of coagulation, anticoagulants, and monitoring tools in pediatric patients receiving ECMO.
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Cho et al. (2017) studied this question.
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