title: Extracorporeal membrane oxygenation-hemostatic complications.
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.
authors.affiliation: 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.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Murphy
authors.affiliation: 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.
authors.forename: Lisen E
authors.initials: LE
authors.lastname: Hockings
authors.affiliation: Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Andrews
authors.affiliation: 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.
authors.forename: Cecile
authors.initials: C
authors.lastname: Aubron
authors.affiliation: Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Gardiner
authors.affiliation: 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.
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Pellegrino
authors.affiliation: Department of Haematology, Alfred Hospital Melbourne, Australia.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Davis
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D002303:Cardiac Output, Low / Q000628:therapy; D002305:Cardiac Tamponade / Q000209:etiology; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006461:Hemolysis; D018056:Hemorheology; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced; D011994:Recombinant Proteins / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000628:therapy; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control; D014842:von Willebrand Diseases / Q000209:etiology
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin
keywords: Anticoagulants; Disseminated intravascular coagulation; Extracorporeal membrane oxygenation; Fibrinolysis; Hemorrhage; Hemostasis; Thrombosis