TY - JOUR
T1 - The Changing Landscape of Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation
T2 - Use of the Direct Thrombin Inhibitors
AU - Neunert, Cindy
AU - Chitlur, Meera
AU - van Ommen, Cornelia Heleen
N1 - Publisher Copyright:
Copyright © 2022 Neunert, Chitlur and van Ommen.
PY - 2022/7/6
Y1 - 2022/7/6
N2 - Bleeding and thrombosis frequently occur in pediatric patients with extracorporeal membrane oxygenation (ECMO) therapy. Until now, most patients are anticoagulated with unfractionated heparin (UFH). However, heparin has many disadvantages, such as binding to other plasma proteins and endothelial cells in addition to antithrombin, causing an unpredictable response, challenging monitoring, development of heparin resistance, and risk of heparin-induced thrombocytopenia (HIT). Direct thrombin inhibitors (DTIs), such as bivalirudin and argatroban, might be a good alternative. This review will discuss the use of both UFH and DTIs in pediatric patients with ECMO therapy.
AB - Bleeding and thrombosis frequently occur in pediatric patients with extracorporeal membrane oxygenation (ECMO) therapy. Until now, most patients are anticoagulated with unfractionated heparin (UFH). However, heparin has many disadvantages, such as binding to other plasma proteins and endothelial cells in addition to antithrombin, causing an unpredictable response, challenging monitoring, development of heparin resistance, and risk of heparin-induced thrombocytopenia (HIT). Direct thrombin inhibitors (DTIs), such as bivalirudin and argatroban, might be a good alternative. This review will discuss the use of both UFH and DTIs in pediatric patients with ECMO therapy.
UR - http://www.scopus.com/inward/record.url?scp=85134566595&partnerID=8YFLogxK
U2 - 10.3389/fmed.2022.887199
DO - 10.3389/fmed.2022.887199
M3 - Review article
C2 - 35872781
AN - SCOPUS:85134566595
SN - 2296-858X
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 887199
ER -