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Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review
Extracorporeal membrane oxygenation (ECMO) has been established as a life-saving technique for patients with the most severe forms of respiratory or cardiac failure. It can, however, be associated with severe complications. Anticoagulation therapy is required to prevent ECMO circuit thrombosis. It i...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782867/ https://www.ncbi.nlm.nih.gov/pubmed/36556985 http://dx.doi.org/10.3390/medicina58121783 |
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author | Burša, Filip Sklienka, Peter Frelich, Michal Jor, Ondřej Ekrtová, Tereza Máca, Jan |
author_facet | Burša, Filip Sklienka, Peter Frelich, Michal Jor, Ondřej Ekrtová, Tereza Máca, Jan |
author_sort | Burša, Filip |
collection | PubMed |
description | Extracorporeal membrane oxygenation (ECMO) has been established as a life-saving technique for patients with the most severe forms of respiratory or cardiac failure. It can, however, be associated with severe complications. Anticoagulation therapy is required to prevent ECMO circuit thrombosis. It is, however, associated with an increased risk of hemocoagulation disorders. Thus, safe anticoagulation is a cornerstone of ECMO therapy. The most frequently used anticoagulant is unfractionated heparin, which can, however, cause significant adverse effects. Novel drugs (e.g., argatroban and bivalirudin) may be superior to heparin in the better predictability of their effects, functioning independently of antithrombin, inhibiting thrombin bound to fibrin, and eliminating heparin-induced thrombocytopenia. It is also necessary to keep in mind that hemocoagulation tests are not specific, and their results, used for setting up the dosage, can be biased by many factors. The knowledge of the advantages and disadvantages of particular drugs, limitations of particular tests, and individualization are cornerstones of prevention against critical events, such as life-threatening bleeding or acute oxygenator failure followed by life-threatening hypoxemia and hemodynamic deterioration. This paper describes the effects of anticoagulant drugs used in ECMO and their monitoring, highlighting specific conditions and factors that might influence coagulation and anticoagulation measurements. |
format | Online Article Text |
id | pubmed-9782867 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97828672022-12-24 Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review Burša, Filip Sklienka, Peter Frelich, Michal Jor, Ondřej Ekrtová, Tereza Máca, Jan Medicina (Kaunas) Review Extracorporeal membrane oxygenation (ECMO) has been established as a life-saving technique for patients with the most severe forms of respiratory or cardiac failure. It can, however, be associated with severe complications. Anticoagulation therapy is required to prevent ECMO circuit thrombosis. It is, however, associated with an increased risk of hemocoagulation disorders. Thus, safe anticoagulation is a cornerstone of ECMO therapy. The most frequently used anticoagulant is unfractionated heparin, which can, however, cause significant adverse effects. Novel drugs (e.g., argatroban and bivalirudin) may be superior to heparin in the better predictability of their effects, functioning independently of antithrombin, inhibiting thrombin bound to fibrin, and eliminating heparin-induced thrombocytopenia. It is also necessary to keep in mind that hemocoagulation tests are not specific, and their results, used for setting up the dosage, can be biased by many factors. The knowledge of the advantages and disadvantages of particular drugs, limitations of particular tests, and individualization are cornerstones of prevention against critical events, such as life-threatening bleeding or acute oxygenator failure followed by life-threatening hypoxemia and hemodynamic deterioration. This paper describes the effects of anticoagulant drugs used in ECMO and their monitoring, highlighting specific conditions and factors that might influence coagulation and anticoagulation measurements. MDPI 2022-12-03 /pmc/articles/PMC9782867/ /pubmed/36556985 http://dx.doi.org/10.3390/medicina58121783 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Burša, Filip Sklienka, Peter Frelich, Michal Jor, Ondřej Ekrtová, Tereza Máca, Jan Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title | Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title_full | Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title_fullStr | Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title_full_unstemmed | Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title_short | Anticoagulation Management during Extracorporeal Membrane Oxygenation—A Mini-Review |
title_sort | anticoagulation management during extracorporeal membrane oxygenation—a mini-review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782867/ https://www.ncbi.nlm.nih.gov/pubmed/36556985 http://dx.doi.org/10.3390/medicina58121783 |
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