ELSO Anticoagulation 2021 — 2021 ELSO Adult and Pediatric Anticoagulation Guidelines
Extracorporeal Life Support Organization, 2022
Anticoagulation during ECMO should be individualized to patient bleeding/thrombotic risk, circuit conditions, center protocol and assay characteristics. UFH is commonly used, but no single anti-Xa, aPTT or ACT target should be presented as universally correct across all ECMO patients; multimodal assessment of coagulation and circuit thrombosis is important.
Clinical Context & Relevant Topics (2)
Disease ReferenceSpecialist-level VV/VA ECMO bedside management: selection, cannulation, gas exchange, hemodynamics, anticoagulation, circuit troubleshooting, organ support, ultrasound, ECPR, weaning and decannulation.
UFH vs LMWH vs DTIs (Argatroban/Bivalirudin), anti-Xa vs aPTT monitoring, and emergency reversal (Protamine, 4F-PCC, Idarucizumab; historical andexanet evidence with current availability caveats).