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Updated: May 27, 2026

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
06:41

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse

Published on: October 24, 2018

Antithrombin replacement during extracorporeal membrane oxygenation.

Robert A Niebler1, Melissa Christensen, Richard Berens

  • 1Department of Pediatrics, Section of Critical Care, The Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI, USA. rniebler@mcw.edu

Artificial Organs
|November 22, 2011
PubMed
Summary

Antithrombin (ATIII) replacement in pediatric ECMO patients increased ATIII activity levels. However, it did not significantly impact anticoagulation or blood loss, suggesting a safe method for managing ATIII deficiency during ECMO.

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Last Updated: May 27, 2026

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
06:41

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse

Published on: October 24, 2018

Area of Science:

  • Pediatric Critical Care Medicine
  • Hematology
  • Cardiovascular Surgery

Background:

  • Heparin is the primary anticoagulant for extracorporeal membrane oxygenation (ECMO).
  • Acquired antithrombin (ATIII) deficiency is common in pediatric ECMO patients, potentially reducing heparin efficacy.
  • ATIII replacement is sometimes used but may increase bleeding risk.

Purpose of the Study:

  • To evaluate the effect of ATIII administration on anticoagulation and blood loss in pediatric patients undergoing ECMO.
  • To determine if ATIII replacement therapy improves anticoagulation control without increasing bleeding complications.

Main Methods:

  • Retrospective chart review of pediatric patients on ECMO who received ATIII at Children's Hospital of Wisconsin in 2009.
  • Comparison of ATIII activity, heparin dose, and activated clotting times (ACT) before and after ATIII administration.
  • Analysis of chest tube output and packed red blood cell (pRBC) transfusion volumes pre- and post-ATIII administration.

Main Results:

  • ATIII activity levels significantly increased at 8 and 24 hours after ATIII administration.
  • No significant differences were observed in heparin drip rates, ACT levels, chest tube output, or pRBC transfusion volumes.
  • ATIII administration effectively increased ATIII activity for 24 hours without adversely affecting anticoagulation or bleeding metrics.

Conclusions:

  • ATIII replacement therapy in pediatric ECMO patients successfully elevates ATIII activity levels.
  • This intervention appears safe, as it does not significantly alter anticoagulation parameters or increase blood loss.
  • ATIII administration is a viable strategy to address ATIII deficiency during ECMO support in pediatric populations.