title: Anticoagulation strategies and difficulties in neonatal and paediatric extracorporeal membrane oxygenation (ECMO).
abstract: OBJECTIVE
  The aim of this review is to highlight an emerging problem with anticoagulation-related complications in neonatal and paediatric ECMO, to explore for flaws in the currently recommended anticoagulation management responsible for these problems and to discuss possible strategies mitigating further escalation of the issue.
  
  
  METHODS
  Pertinent neonatal and paediatric literature on the topic of interest and international Extracorporeal Life Support Organisation (ELSO) registry data request.
  
  
  CONCLUSIONS
  The international ELSO registry data reveals increasing rates of anticoagulation-related complications during neonatal and paediatric ECMO worldwide. The causes are multifactorial and the proposed solution to the problem is to match anticoagulation management to the pathophysiological complexity of haemostasis on ECMO.
authors.affiliation: Paediatric Intensive Care Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia Christian.Stocker@health.qld.gov.au.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Stocker
authors.affiliation: Paediatric Perfusion Unit, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Horton
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods; D006487:Hemostasis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn
chemical_list: D000925:Anticoagulants
keywords: ECLS; ECMO; anticoagulation; complications; neonatal; paediatric