Anticoagulant Monitoring in ECMO

Here’s a provocative open-access essay that reviews the efficacy of current anticoagulant monitoring in ECMO: Rajsic S, Treml B. Anticoagulation monitoring during ECMO support: monitor or flip a coin? Clin Cardiol. 2024;47(12):e70061. doi: 10.1002/clc.70061. PMID: 39692163; PMCID: PMC11653157.

Abstract

Should we rely on anticoagulation monitoring in ECMO patients or simply flip a coin? The increasing use of anti-factor Xa activity to monitor the effect of UFH appears appropriate, given its moderate correlation with the UFH infusion rates, and it may play a role in preventing thromboembolic events. However, to avoid bleeding complications, more sophisticated tools and careful clinical decision-making remain essential.