The Changing Landscape of Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation: Use of the Direct Thrombin Inhibitors

Frontiers in Medicine

article

Cindy Neunert¹  Meera Chitlur²  Cornelia Heleen van Ommen³ 

[1] Department of Pediatrics, Columbia University Medical Center;Division of Hematology, Oncology, Carmen and Ann Adams Department of Pediatrics, Children’s Hospital of Michigan, Central Michigan University;Department of Pediatric Hematology and Oncology, Erasmus Medical Center University Medical Center Sophia Children’s Hospital

关键词: extracorporeal membrane oxygenation;    anticoagulation;    unfractionated heparin;    bivalirudin;    pediatric;    argatroban;   

DOI  :  10.3389/fmed.2022.887199

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Bleeding and thrombosis frequently occur in pediatric patients with extracorporeal membrane oxygenation (ECMO) therapy. Until now, most patients are anticoagulated with unfractionated heparin (UFH). However, heparin has many disadvantages, such as binding to other plasma proteins and endothelial cells in addition to antithrombin, causing an unpredictable response, challenging monitoring, development of heparin resistance, and risk of heparin-induced thrombocytopenia (HIT). Direct thrombin inhibitors (DTIs), such as bivalirudin and argatroban, might be a good alternative. This review will discuss the use of both UFH and DTIs in pediatric patients with ECMO therapy.

【 授权许可】

CC BY