Anticoagulation Monitoring and Targets: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative Consensus Conference
Research article published in Pediatric critical care medicine (2024)
Abstract
OBJECTIVES: To derive systematic-review informed, modified Delphi consensus regarding anticoagulation monitoring assays and target levels in pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE. DATA SOURCES: A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021. STUDY SELECTION: Anticoagulation monitoring of pediatric patients on ECMO. DATA EXTRACTION: Two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts. Evidence tables were constructed using a standardized data extraction form. DATA SYNTHESIS: Risk of bias was assessed using the Quality in Prognosis Studies tool or the revised Cochrane risk of bias for randomized trials, as appropriate and the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. Forty-eight experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements for clinical recommendations focused on anticoagulation monitoring and targets, using a web-based modified Delphi process to build consensus (defined as > 80% agreement). One weak recommendation, two consensus statements, and three good practice statements were developed and, in all, agreement greater than 80% was reached. We also derived some resources for anticoagulation monitoring for ECMO clinician use at the bedside. CONCLUSIONS: There is insufficient evidence to formulate optimal anticoagulation monitoring during pediatric ECMO, but we propose one recommendation, two consensus and three good practice statements. Overall, the available pediatric evidence is poor and significant gaps exist in the literature.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Anticoagulation Monitoring and Targets: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative Consensus Conference.
Por qué esto importa para la hirudoterapia
This systematic-review-informed consensus statement from the Pediatric ECMO Anticoagulation Collaborative addresses anticoagulation monitoring assays and target levels in pediatric extracorporeal membrane oxygenation. Over two years, 48 experts developed one weak recommendation, two consensus statements, and three good practice statements using a modified Delphi process (>80% agreement). The authors concluded that evidence is insufficient to define optimal anticoagulation monitoring during pediatric ECMO, with significant gaps in the literature. The relevance to ASH and hirudotherapy is only indirect: the abstract does not mention leeches, hirudin, or bivalirudin specifically, focusing instead on general anticoagulation management. While anticoagulation is conceptually adjacent to leech-derived therapeutics, this document provides no direct data on leech-derived agents and should be considered background context rather than primary hirudotherapy literature.
Citación
Anticoagulation Monitoring and Targets: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative Consensus Conference
Ozment CP et al. · Pediatric critical care medicine, 2024
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026