Hematologic concerns in extracorporeal membrane oxygenation

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Hematologic concerns in extracorporeal membrane oxygenation

Abstract

This ISTH “State of the Art” review aims to critically evaluate the hematologic considerations and complications in extracorporeal membrane oxygenation (ECMO). ECMO is experiencing a rapid increase in clinical use, but many questions remain unanswered. The existing literature does not address or explicitly state many pertinent details that may influence hematologic complications and, ultimately, patient outcomes. This review aims to broadly introduce modern ECMO practices, circuit designs, circuit materials, hematologic complications, transfusion‐related considerations, age‐ and size‐related differences, and considerations for choosing outcome measures. Relevant studies from the 2019 ISTH Congress in Melbourne, which further advanced our understanding of these processes, will also be highlighted.

Essentials

Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with severe lung or heart failure. Its use can affect the blood in many complex and poorly understood ways, leading to excessive bleeding or clotting.
Few ECMO studies comprehensively describe the factors that can affect these complications, such as circuit design or blood product transfusion.
The best ways of preventing these complications are unknown.
A common language is needed to better understand them and to facilitate more detailed research.

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