Use of Coagulation Algorithm at the Bedside During Extra Corporeal Membrane Oxygenation (ECMO) in Neonatal and Pediatric Patients

Abstract

It can be difficult to achieve the perfect balance of coagulation of the blood for patients on extra corporeal membrane oxygenation (ECMO) therapy. The anticoagulation of the blood must be adequate to allow the ECMO pump to run smoothly, but prevent patient bleeding. This study focused on the introduction of a coagulation algorithm used by the ECMO specialist. The study compared the number of complications prior to and after the algorithm was implemented. The use of the ECMO Coagulation Algorithm was found to be associated with an increase in pump clotting complications and an increase in Atryn boluses, though patient acuity was also higher in the group using the algorithm. Although the algorithm was not useful in decreasing the rate of complications from ECMO, it does appear to be a useful, educational tool for assisting the novice ECMO specialist with an understanding of the complicated partial coagulation pathway used with ECMO patients.