American Society of Hirudotherapy

Anticoagulation during ECMO in neonatal and paediatric patients.

Review published in Thrombosis research (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsDrug DevelopmentBarton et al. · Thrombosis research, 2018

Abstract

Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsBlood Coagulation TestsChildDrug MonitoringExtracorporeal Membrane OxygenationHemorrhageHemostasisHumansInfantThrombosis

Summary

Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to...

Why This Matters for Hirudotherapy

This article discusses anticoagulation management during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients, noting that systemic anticoagulation is required to prevent patient and circuit-based thrombosis but increases hemorrhage risk, and that evidence for correlation between coagulation test results, anticoagulant levels, and clinical outcomes in children remains poor. This topic holds relevance for ASH and hirudotherapy because anticoagulation is central to leech therapy, and direct thrombin inhibitors derived from or modeled on medicinal-leech hirudin represent one class of anticoagulants for which optimal monitoring strategies remain an open clinical question. A limitation is that the abstract provides a general discussion without reporting specific data, sample sizes, or intervention outcomes, so it does not establish the effectiveness of any particular anticoagulant or monitoring approach.

Citation

Anticoagulation during ECMO in neonatal and paediatric patients.

Barton et al. · Thrombosis research, 2018

DOI

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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