ECMO and anticoagulation: A comprehensive review

doi:N/A

eISSN: None / ISSN: None

Netharland Journal of Critical Care

2018, Volume 26, Issue 1 : 6-13

Review

ECMO and anticoagulation: A comprehensive review

Mulder M.M.G.

Fawzy I.

Lancé M.D.

Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, Netherlands

Department of Medical Intensive Care, Hamad Medical Corporation, Doha, Qatar

Department of Anaesthesiology, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar

Abstract

Since the last decade extracorporeal membrane oxygenation (ECMO) therapy has been widely accepted as the treatment of life-threatening cardiac and pulmonary failure. Maintaining homeostasis of the haemostatic system remains a major challenge. The choice of anticoagulants to inhibit continuous activation of coagulation by the non-endothelialised systems is still restricted. The most widely used agent is intravenous unfractionated heparin. Although one might expect monitoring of the anticoagulant level to be straightforward, the number of bleeding or thrombotic complications is still too high. In this review, we report the impact of an extracorporeal circuit on the coagulation system and its complications. We describe the strategies for anticoagulation and possibilities of monitoring their effects. Finally, we give a view of the future developments in this specific field. © 2018 NVIC. All rights reserved.

Keywords

Bleeding

Coagulation

ECLS

ECMO

Thrombosis

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

All papers should be submitted electronically. All submitted manuscripts must be original work that is not under submission at another journal or under consideration for publication in another form, such as a monograph or chapter of a book. Authors of submitted papers are obligated not to submit their paper for publication elsewhere until an editorial decision is rendered on their submission. Further, authors of accepted papers are prohibited from publishing the results in other publications that appear before the paper is published in the Journal unless they receive approval for doing so from the Editor-In-Chief.

Neth. J. Crit. Care open access articles are licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets the audience to give appropriate credit, provide a link to the license, and indicate if changes were made and if they remix, transform, or build upon the material, they must distribute contributions under the same license as the original.

Recommended Articles

Right ventricular failure: Is it relevant for the intensivist?

van Dijk D.

96-97

Neuropsychological Predictors of Violent Criminal Behavior

Raymond H. Ellis,

Shruti Banerjee,

Kazuo Takayama

1-6

Postoperative renal replacement therapy after hydroxyethyl starch infusion: A meta-analysis of randomised trials

Wilkes M.M.,

Navickis R.J.