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Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

2.5K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Updated: Feb 15, 2026

Assessment of the Anticoagulant and Anti-inflammatory Properties of Endothelial Cells Using 3D Cell Culture and Non-anticoagulated Whole Blood
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Anticoagulation in neonatal ECMO.

Aditi Kamdar1, Natalie Rintoul2, Leslie Raffini2

  • 1Division of Hematology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Seminars in Perinatology
|January 17, 2018
PubMed
Summary
This summary is machine-generated.

Managing blood clotting for neonates on extracorporeal membrane oxygenation (ECMO) is challenging due to their developing systems. This review examines current anticoagulation methods and limitations in neonates during ECMO.

Keywords:
AnticoagulationHemostasisHeparinUnfractionated heparin

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Area of Science:

  • Neonatal intensive care
  • Pediatric hematology
  • Extracorporeal membrane oxygenation (ECMO)

Background:

  • Hemorrhagic and thrombotic complications are frequent in neonates undergoing ECMO, impacting patient outcomes.
  • Anticoagulation management in neonates presents unique challenges due to their immature hemostatic systems, differing significantly from adult protocols.
  • Current practices for anticoagulation monitoring and titration in neonates on ECMO show considerable variation among centers, highlighting a need for evidence-based guidelines.

Purpose of the Study:

  • To review the hemostatic alterations observed in neonates during ECMO therapy.
  • To critically evaluate current approaches and limitations in anticoagulation titration for neonates on ECMO.
  • To discuss potential alternative anticoagulant options and the need for further research.

Main Methods:

  • Review of existing literature on hemostasis and anticoagulation in neonates undergoing ECMO.
  • Analysis of current clinical practices and variations in anticoagulation management.
  • Discussion of challenges in monitoring and titrating anticoagulants in this population.

Main Results:

  • Neonates on ECMO experience significant hemostatic system alterations.
  • Current anticoagulation strategies are often based on limited evidence, leading to practice variability.
  • The developing hemostatic system in neonates complicates standard adult anticoagulation protocols.

Conclusions:

  • Effective anticoagulation management remains a critical challenge in neonates receiving ECMO.
  • There is a significant need for high-quality evidence to guide anticoagulation titration and improve outcomes.
  • Further investigation into novel anticoagulants and refined management strategies is essential for this vulnerable patient group.