Anticoagulation-free VV ECMO for Acute Respiratory Failure

Launched by DAMIAN RATANO · Feb 13, 2020

Keywords

ClinConnect Summary

Although anticoagulation targets and monitoring strategies vary around the world, the current practice is still to anticoagulate patients on ECMO, mostly with UFH. However, the use of heparin coated circuits has changed their thrombogenicity. Preliminary data suggest that a low-dose unfractionated heparin (UFH) strategy is non-inferior to a therapeutic dose UFH. Indeed, in daily practice, when a patient on ECMO has severe bleeding complications, UFH is often stopped until the hemorrhagic issue is under control, sometimes for days. This has led some to hypothesize that anticoagulation might ...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patient with ARDS on VV-ECMO
• Exclusion Criteria:
• • Contraindication to anticoagulation with UFH (known heparin-induced thrombocytopenia, active hemorrhage, any surgery precluding the use of anticoagulation),
• • Indication for therapeutic anticoagulation (pulmonary embolism or deep vein thrombosis, chronic anticoagulation therapy before ECMO insertion)
• • Low-flow (\<2 liters/min) VV-ECMO (ECCO2R)

Trial Officials