Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Protocol Associated with a Decrease in Complications

Abstract

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Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

“…Protocolized management is often employed for complex anticoagulation management including during e85 the management of critically ill children supported with ECMO (35,55,(63)(64)(65)(66)(67)(68)(69)(70). Advantages of protocolized management include consistency in clinical care; reduction in the cognitive load of frequent decisions for complex, high-risk patients; small total patient numbers in most centers such that institutional expertise is difficult to maintain across all providers; and the multidisciplinary nature of ECMO care (55,63,70).…”

Balancing Pharmacologic Anticoagulation in Extracorporeal Membrane Oxygenation: Is It Now Time to Follow the Path Less Taken?*

“…While the need for standardization to facilitate ECMO-related research, particularly in areas addressing anticoagulation practices, has long been recognized, standardized anticoagulation regimens have not been adopted (6, 7, 21–25). However, a reduction in bleeding and thrombotic complications in ECMO following the application of standardized decision-making processes has been demonstrated in a few studies (26, 27), suggesting that broader standardization may result in meaningful improvement in how we manage anticoagulation in pediatric ECMO. Recognizing the current lack of high-quality data in the current literature, the PEACE investigators included recommendations for future research to address these “gaps” in knowledge; the PEACE research recommendations are contained in Table 6 (10) of their executive summary.…”