Anticoagulation in ECMO patients: an overview

Extracorporeal membrane oxygenation (ECMO) is a form of cardiorespiratory support, and is being increasingly used to support refractory heart and respiratory failure. It involves draining blood from the vascular system, which is then circulated outside the body by a mechanical pump and then later reinfused back into the circulation. The blood that is circulated outside the body comes in contact with a large surface area of non-endothelial biosurface. This exposure leads to a pro-thrombotic state, and hence anticoagulation is required. Unfractionated heparin is the most commonly used anticoagulation in most ECMO centers, but it does require close monitoring. Despite the advances made, hemostasis remains a challenge for physicians who manage patients on ECMO.

Automated summary

Extracorporeal membrane oxygenation (ECMO) is a form of cardiorespiratory support increasingly used for refractory heart and respiratory failure. Blood drained from the vascular system is circulated outside the body and reinfused into circulation, but contact with a non-endothelial biosurface can lead to a pro-thrombotic state, requiring anticoagulation and close monitoring. Despite advances, managing hemostasis on ECMO remains a challenge for physicians.