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. 2016 Apr;4(7):139.
doi: 10.21037/atm.2016.03.06.

The delicate balance between pro-(risk of thrombosis) and anti-(risk of bleeding) coagulation during extracorporeal membrane oxygenation

Alessandro Protti  1 , Camilla L'Acqua  1 , Mauro Panigada  1
Affiliations

The delicate balance between pro-(risk of thrombosis) and anti-(risk of bleeding) coagulation during extracorporeal membrane oxygenation

Alessandro Protti et al. Ann Transl Med. 2016 Apr.
No abstract available

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Our current protocol for infusing unfractionated heparin during VV-ECMO. We administer unfractionated heparin (UFH) as a bolus at the time of insertion of vascular cannulas and as a continuous infusion thereafter, with an aPTT ratio target of 1.5–2.0. We normally check aPTT every 8 hours. If aPTT is not in target, we react according to a standardized protocol. For example, if aPTT ratio is lower than 1.2, we administer a bolus (20 IU/kg), we increase continuous infusion rate by 20% and we check aPTT after 2 hours. If aPTT ratio is higher than 2.5, we suspend continuous infusion of UFH for 60 minutes. We then restart it at a 30% lower rate and check aPTT after 2 hours. Heparin dosage is computed according to actual body weight. Please refer to main manuscript for further details. VV-ECMO, veno-venous extracorporeal membrane oxygenation.
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