PMID- 37967498
OWN - NLM
STAT- MEDLINE
DCOM- 20231204
LR  - 20231204
IS  - 1532-9453 (Electronic)
IS  - 1055-8586 (Linking)
VI  - 32
IP  - 4
DP  - 2023 Aug
TI  - Systemic anticoagulation in ECMO.
PG  - 151333
LID - S1055-8586(23)00080-X [pii]
LID - 10.1016/j.sempedsurg.2023.151333 [doi]
AB  - While unfractionated heparin (UFH) remains the mainstay of anticoagulation during 
      pediatric extracorporeal life support, direct thrombin inhibitors (DTIs) are 
      increasingly used. In this article, we will review most recent evidence regarding 
      utilization of both UFH and DTIs and compare their known advantages and 
      disadvantages. We will present anticoagulation monitoring strategies during ECMO 
      and outline the most recent Extracorporeal Life Support Organization's 
      anticoagulation guidelines, however with the caveat that there are no true 
      consensus recommendations for anticoagulation management in pediatric ECMO. With 
      these updates, we will serve as the bedside clinician's refresher on common 
      practices for anticoagulation during "routine" ECMO. We will additionally 
      highlight special circumstances, including high risk surgical procedures during 
      ECMO, in which adjustments in anticoagulation and/or addition of antifibrinolytic 
      therapy might mitigate risk.
CI  - Copyright (c) 2023. Published by Elsevier Inc.
FAU - Larabee, Shannon M
AU  - Larabee SM
AD  - Texas Children's Hospital and Baylor College of Medicine, United States.
FAU - Hollinger, Laura E
AU  - Hollinger LE
AD  - Medical University of South Carolina, United States. Electronic address: 
      hollingl@musc.edu.
FAU - Vogel, Adam M
AU  - Vogel AM
AD  - Texas Children's Hospital and Baylor College of Medicine, United States.
LA  - eng
PT  - Journal Article
DEP - 20231021
PL  - United States
TA  - Semin Pediatr Surg
JT  - Seminars in pediatric surgery
JID - 9216162
RN  - 9005-49-6 (Heparin)
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Humans
MH  - Child
MH  - *Heparin/therapeutic use
MH  - Anticoagulants/therapeutic use
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Blood Coagulation Tests/methods
OTO - NOTNLM
OT  - Activated clotting time
OT  - Activated partial thromboplastin time
OT  - Anti-Xa
OT  - Anticoagulation
OT  - Dilute thrombin time
OT  - Extracorporeal membrane oxygenation
OT  - Heparin, Direct thrombin inhibitors
OT  - Viscoelastic assays
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this pape.
EDAT- 2023/11/16 00:42
MHDA- 2023/12/04 12:42
CRDT- 2023/11/15 18:00
PHST- 2023/12/04 12:42 [medline]
PHST- 2023/11/16 00:42 [pubmed]
PHST- 2023/11/15 18:00 [entrez]
AID - S1055-8586(23)00080-X [pii]
AID - 10.1016/j.sempedsurg.2023.151333 [doi]
PST - ppublish
SO  - Semin Pediatr Surg. 2023 Aug;32(4):151333. doi: 10.1016/j.sempedsurg.2023.151333. 
      Epub 2023 Oct 21.