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Hematologic concerns in extracorporeal membrane oxygenation.

Jonathan Sniderman1, Paul Monagle2, Gail M Annich3

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|June 18, 2020
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Summary

Extracorporeal membrane oxygenation (ECMO) use is rising, but hematologic complications require more research. This review addresses ECMO practices, complications, and outcomes to improve patient care.

Keywords:
adultextracorporeal membrane oxygenationhemolysishemorrhagepediatricthrombosis

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Area of Science:

  • Hematology
  • Cardiopulmonary Bypass
  • Critical Care Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) is increasingly utilized in clinical settings.
  • Significant knowledge gaps persist regarding hematologic considerations and complications associated with ECMO.
  • Existing literature often lacks critical details influencing hematologic issues and patient outcomes.

Purpose of the Study:

  • To critically evaluate hematologic considerations and complications in ECMO.
  • To provide a comprehensive overview of modern ECMO practices and associated hematologic challenges.
  • To highlight advancements in understanding ECMO-related hematology from the 2019 ISTH Congress.

Main Methods:

  • Literature review focusing on hematologic aspects of ECMO.
  • Analysis of current ECMO practices, including circuit designs and materials.
  • Inclusion of relevant findings from the 2019 International Society on Thrombosis and Haemostasis (ISTH) Congress.

Main Results:

  • Identified gaps in understanding ECMO-related hematologic complications.
  • Discussed transfusion strategies and age/size-related differences in ECMO patients.
  • Examined considerations for selecting appropriate outcome measures in ECMO research.

Conclusions:

  • Further research is needed to address unanswered questions in ECMO hematology.
  • Standardized approaches to managing hematologic complications are crucial for optimizing patient outcomes.
  • Enhanced understanding of ECMO's impact on hematology can guide clinical practice and future research.