The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
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J Pediatr Pharmacol Ther · Jan 2005
Control of Coagulation during Extracorporeal Membrane Oxygenation.
The use of extracorporeal membrane oxygenation (ECMO) requires maintaining a delicate balance between the prevention of thrombosis and the avoidance of hemorrhage. Anticoagulation is necessary to maintain circuit flow. It counteracts the activation of clotting mechanisms that occurs as a result of the interaction between circulating blood and the foreign surfaces of the ECMO equipment as well as endothelial damage within the vasculature. ⋯ In addition, thrombolysis with alteplase is now being used in patients who develop clots despite anticoagulation. Aminocaproic acid has been used for more than a decade to manage or prevent hemorrhage in patients on ECMO, but a new report suggests that activated recombinant factor VII may also be useful as a hemostatic agent. Over the next decade, it is likely that the role of these newer agents will grow, making them important tools in the management of patients on ECMO.