Related Experiment Video
Updated: Jan 10, 2026
03:40
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
776
Antithrombin Supplementation in Extracorporeal Membrane Oxygenation: A Systematic Review With Meta-Analysis
Abigail G Elliott1, Hannah M Brinkman1, Troy G Seelhammer2
1Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.
Artificial Organs
|November 20, 2025
Summary
Antithrombin supplementation during extracorporeal membrane oxygenation (ECMO) showed no difference in bleeding, thrombosis, or mortality. However, it may increase thrombotic events in pediatric patients on ECMO.
Area of Science:
- Critical Care Medicine
- Hematology
- Pediatric Critical Care
Background:
- Extracorporeal membrane oxygenation (ECMO) management guidelines recommend antithrombin monitoring and supplementation.
- Evidence supporting routine antithrombin use in ECMO is uncertain.
- The clinical benefit or harm of antithrombin supplementation during ECMO is unclear.
Purpose of the Study:
- To evaluate the safety and efficacy of antithrombin supplementation in patients undergoing ECMO.
- To determine the impact of antithrombin supplementation on bleeding, thrombosis, and mortality.
- To explore potential differences in outcomes between pediatric and adult patients.
Main Methods:
- Systematic review and meta-analysis of 11 studies.
- Comparison of ECMO patients who received antithrombin supplementation versus those who did not.
- Random effects meta-analysis with subgroup and sensitivity analyses.
Main Results:
- Antithrombin supplementation did not significantly alter bleeding events, thrombotic events, or mortality.
- No differences in bleeding or mortality were observed in pediatric or adult subgroups.
- Pediatric patients receiving antithrombin showed a higher likelihood of thrombotic events.
Conclusions:
- Antithrombin supplementation during ECMO is not associated with improved mortality or hemostatic outcomes.
- Antithrombin supplementation may be associated with increased harm, specifically thrombotic events, in pediatric patients on ECMO.
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