Patient Blood Management in Adult Extracorporeal Membrane Oxygenation Patients

Document Type

Journal Article

Publication Date

6-1-2020

Journal

Current Anesthesiology Reports

Volume

10

Issue

2

DOI

10.1007/s40140-020-00384-8

Keywords

Bleeding; Coagulation; ECMO; Transfusion

Abstract

Purpose of Review: This narrative review provides a framework for contemporary patient blood management (PBM) in adult extracorporeal membrane oxygenation (ECMO) patients. Recent Findings: ECMO use is growing in adults with cardiopulmonary failure and bleeding, and allogeneic transfusion is common. There are no high quality randomized controlled trials to guide transfusion strategies or anticoagulation. Recent studies offer some insight into the coagulation changes that occur during ECMO, optimal anticoagulation practices, and potential therapies for bleeding. Summary: PBM for adult ECMO patients should be grounded in an understanding of the coagulation changes that occur during ECMO and evidence-based transfusion medicine practices. As randomized controlled trials are completed, PBM will continue to mature, which should help to improve outcomes and reduce costs for ECMO patients.

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