Why the study?
Severe thrombocytopenia carries a high bleeding risk and is a relative contraindication to anticoagulation and ECMO, motivating evaluation of long-term ECMO without systemic anticoagulation.
Is venovenous ECMO without systemic anticoagulation feasible and safe in adult patients with severe thrombocytopenia?
Population
7 immunocompromised adult patients with thrombocytopenia < 50 G/L undergoing venovenous ECMO
Comparison
Venovenous ECMO with systemic anticoagulation withdrawn for ≥3 days
Design
Retrospective case series
Authors
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Suggests anticoagulant-free ECMO is technically feasible in severe thrombocytopenia but carries prohibitive bleeding risks;.
Is venovenous ECMO without systemic anticoagulation feasible and safe in adult patients with severe thrombocytopenia?
Running ECMO without systemic anticoagulation in patients with severe thrombocytopenia is technically feasible with rare clotting events, but bleeding remains common and overall prognosis is very poor.
Hermann et al. (2019) studied this question.
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