Related Experiment Video

Updated: Jan 24, 2026

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

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse

Published on: October 24, 2018

13.0K

Routine laboratory measures of heparin anticoagulation for children on extracorporeal membrane oxygenation:

D R Padhya1, G J Prutsky2, M E Nemergut3

  • 1Department of Pediatrics, Reading Hospital, Reading, PA, USA.

Thrombosis Research
|May 28, 2019
PubMed

Insights

For children on ECMO, Anti-Xa is the most suitable test for monitoring heparin anticoagulation. It correlates well with heparin dosing and helps predict complications, unlike other lab tests.

Area of Science:

  • Pediatric Critical Care Medicine
  • Hematology
  • Cardiopulmonary Bypass

Background:

  • Anticoagulation management in pediatric Extracorporeal Membrane Oxygenation (ECMO) is complex, with varied institutional protocols.
  • Unfractionated heparin is commonly used, necessitating reliable monitoring methods.

Purpose of the Study:

  • To identify the optimal laboratory test for monitoring heparin anticoagulation in pediatric ECMO patients.
  • To determine which test best correlates with heparin activity and predicts hemorrhagic or thrombotic complications.

Main Methods:

  • A systematic literature search was performed across major databases (MEDLINE, EMBASE, Cochrane, Scopus) up to July 2018.
  • Included studies evaluated children (<18 years) on ECMO, assessing activated clotting time (ACT), activated partial thromboplastin time (aPTT), thromboelastography (TEG), and Anti-Xa.
  • Data extraction and study appraisal were conducted independently by two reviewers.

Main Results:

  • Nineteen studies involving 759 pediatric patients were analyzed.
  • A strong correlation was found between heparin dosing and Anti-Xa levels.
  • No strong correlation was observed between laboratory tests and clinical outcomes like hemorrhage, thrombosis, or mortality.

Conclusions:

  • Anti-Xa is the most suitable laboratory test for monitoring heparin anticoagulation in pediatric ECMO patients.
  • This test demonstrates a strong correlation with heparin infusion rates.
  • Current evidence suggests Anti-Xa is superior to ACT, aPTT, and TEG for this specific clinical application.
Abstract

Keywords:
AnticoagulationComplicationsExtracorporeal membrane oxygenationLaboratory measuresPediatrics

More Related Videos

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

810
Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia04:34

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia

Published on: February 17, 2023

1.6K

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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...
1.8K
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

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...
2.2K
Review and Preview01:10

Review and Preview

In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
8.3K
Review and Preview01:13

Review and Preview

Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
10.9K
Special considerations while measuring oxygen saturation01:19

Special considerations while measuring oxygen saturation

Assessing respiratory rate concurrently with pulse measurement is fundamental to patient care, providing valuable insights into the patient's respiratory function. The normal breathing rate for an adult usually falls within a normal range of 12 to 20 breaths per minute. Abnormal respiratory rates can signal underlying health conditions or the need for immediate intervention.
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
930
Random and Systematic Errors01:20

Random and Systematic Errors

Scientists always try their best to record measurements with the utmost accuracy and precision. However, sometimes errors do occur. These errors can be random or systematic. Random errors are observed due to the inconsistency or fluctuation in the measurement process, or variations in the quantity itself that is being measured. Such errors fluctuate from being greater than or less than the true value in repeated measurements. Consider a scientist measuring the length of an earthworm using a...
14.7K