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Transfus Med Rev. 2015 Apr;29(2):90-101. doi: 10.1016/j.tmrv.2014.12.001. Epub 2014 Dec 18.

Extracorporeal membrane oxygenation-hemostatic complications.

Author information

1
Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, School of Public Health, Monash University, Melbourne, Australia. Electronic address: d.murphy@alfred.org.au.
2
Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, School of Public Health, Monash University, Melbourne, Australia.
3
Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
4
ANZIC Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
5
Department of Haematology, Alfred Hospital Melbourne, Australia.

Abstract

The use of extracorporeal membrane oxygenation (ECMO) support for cardiac and respiratory failure has increased in recent years. Improvements in ECMO oxygenator and pump technologies have aided this increase in utilization. Additionally, reports of successful outcomes in supporting patients with respiratory failure during the 2009 H1N1 pandemic and reports of ECMO during cardiopulmonary resuscitation have led to increased uptake of ECMO. Patients requiring ECMO are a heterogenous group of critically ill patients with cardiac and respiratory failure. Bleeding and thrombotic complications remain a leading cause of morbidity and mortality in patients on ECMO. In this review, we describe the mechanisms and management of hemostatic, thrombotic and hemolytic complications during ECMO support.

KEYWORDS:

Anticoagulants; Disseminated intravascular coagulation; Extracorporeal membrane oxygenation; Fibrinolysis; Hemorrhage; Hemostasis; Thrombosis

PMID:
25595476
DOI:
10.1016/j.tmrv.2014.12.001
[Indexed for MEDLINE]

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