Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children
Extracorporeal Membrane Oxygenation (ECMO) is often used in critically ill children with severe cardiopulmonary failure. Worldwide, about 3600 children are supported by ECMO each year, with an increase of 10% in cases per year. Although anticoagulation is necessary to prevent circuit thrombosis duri...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Pediatric Reports |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2036-7503/14/3/39 |
| _version_ | 1827657965914554368 |
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| author | Madhuradhar Chegondi Niranjan Vijayakumar Balagangadhar R. Totapally |
| author_facet | Madhuradhar Chegondi Niranjan Vijayakumar Balagangadhar R. Totapally |
| author_sort | Madhuradhar Chegondi |
| collection | DOAJ |
| description | Extracorporeal Membrane Oxygenation (ECMO) is often used in critically ill children with severe cardiopulmonary failure. Worldwide, about 3600 children are supported by ECMO each year, with an increase of 10% in cases per year. Although anticoagulation is necessary to prevent circuit thrombosis during ECMO support, bleeding and thrombosis are associated with significantly increased mortality risk. In addition, maintaining balanced hemostasis is a challenging task during ECMO support. While heparin is a standard anticoagulation therapy in ECMO, recently, newer anticoagulant agents are also in use. Currently, there is a wide variation in anticoagulation management and diagnostic monitoring in children receiving ECMO. This review intends to describe the pathophysiology of coagulation during ECMO support, review of literature on current and newer anticoagulant agents, and outline various diagnostic tests used for anticoagulation monitoring. We will also discuss knowledge gaps and future areas of research. |
| first_indexed | 2024-03-09T22:52:18Z |
| format | Article |
| id | doaj.art-648565cfca1448639dcd6ee4ca62f52a |
| institution | Directory Open Access Journal |
| issn | 2036-7503 |
| language | English |
| last_indexed | 2024-03-09T22:52:18Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pediatric Reports |
| spelling | doaj.art-648565cfca1448639dcd6ee4ca62f52a2023-11-23T18:17:15ZengMDPI AGPediatric Reports2036-75032022-07-0114332033210.3390/pediatric14030039Management of Anticoagulation during Extracorporeal Membrane Oxygenation in ChildrenMadhuradhar Chegondi0Niranjan Vijayakumar1Balagangadhar R. Totapally2Division of Pediatric Critical Care Medicine, Stead Family Children’s Hospital, University of Iowa, Iowa City, IA 52242, USADivision of Cardiac Critical Care, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USADivision of Critical Care Medicine, Nicklaus Children’s Hospital, Miami, FL 33155, USAExtracorporeal Membrane Oxygenation (ECMO) is often used in critically ill children with severe cardiopulmonary failure. Worldwide, about 3600 children are supported by ECMO each year, with an increase of 10% in cases per year. Although anticoagulation is necessary to prevent circuit thrombosis during ECMO support, bleeding and thrombosis are associated with significantly increased mortality risk. In addition, maintaining balanced hemostasis is a challenging task during ECMO support. While heparin is a standard anticoagulation therapy in ECMO, recently, newer anticoagulant agents are also in use. Currently, there is a wide variation in anticoagulation management and diagnostic monitoring in children receiving ECMO. This review intends to describe the pathophysiology of coagulation during ECMO support, review of literature on current and newer anticoagulant agents, and outline various diagnostic tests used for anticoagulation monitoring. We will also discuss knowledge gaps and future areas of research.https://www.mdpi.com/2036-7503/14/3/39extracorporeal membrane oxygenationECMOextracorporeal life supportanticoagulationbleedingthrombosis |
| spellingShingle | Madhuradhar Chegondi Niranjan Vijayakumar Balagangadhar R. Totapally Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children Pediatric Reports extracorporeal membrane oxygenation ECMO extracorporeal life support anticoagulation bleeding thrombosis |
| title | Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children |
| title_full | Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children |
| title_fullStr | Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children |
| title_full_unstemmed | Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children |
| title_short | Management of Anticoagulation during Extracorporeal Membrane Oxygenation in Children |
| title_sort | management of anticoagulation during extracorporeal membrane oxygenation in children |
| topic | extracorporeal membrane oxygenation ECMO extracorporeal life support anticoagulation bleeding thrombosis |
| url | https://www.mdpi.com/2036-7503/14/3/39 |
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