Chonnam Med J.  2017 May;53(2):110-117. 10.4068/cmj.2017.53.2.110.

Anticoagulation Therapy during Extracorporeal Membrane Oxygenator Support in Pediatric Patients

Affiliations
  • 1Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
  • 2Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. isjeong1201@gmail.com
  • 3Extracorporeal Life Support Organization, Asia-Pacific Chapter, Ann Arbor, MI, USA.

Abstract

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.

Keyword

Extracorporeal Membrane Oxygenation; Extracorporeal Life Support; Anticoagulation; Pediatrics

MeSH Terms

Adult
Anticoagulants
Cause of Death
Critical Illness
Extracorporeal Membrane Oxygenation
Humans
Membranes*
Oxygen
Oxygenators
Oxygenators, Membrane*
Pediatrics
Salvage Therapy
Anticoagulants
Oxygen

Figure

  • FIG. 1 Schema of blood-artificial surface interaction that leads to thrombus formation.


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