Abstract
Objective: Specific protocols for anticoagulation for children on ECMO vary across institutions, with most using a continuous infusion of unfractionated heparin. The goal of this study is to aid clinician's decision on the best measure of heparin anticoagulation test; which would be the one that correlates well with heparin activity and helps in predicting hemorrhagic and thrombotic complications. Data sources: A comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus was conducted from each database's inception to 07/13/2018. Study selection: Studies evaluating children (<18 years)treated with ECMO and evaluating ACT, aPTT, TEG and Anti-Xa in any language were included. Data extraction: Two reviewers selected and appraised studies independently, and abstracted data. Results: We included 19 studies (759 patients, mean age 19.8 months). Meta-analysis showed strong correlation between heparin dosing and anti-Xa. Additionally, there was not a strong correlation between laboratory tests and complications (hemorrhagic and thrombosis), or mortality. Conclusion: Based on current evidence, Anti-Xa is the only laboratory test that shows strong correlation with heparin infusion dose and seems like the most suitable test for monitoring of anticoagulation with heparin in children on ECMO.
Original language | English (US) |
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Pages (from-to) | 132-139 |
Number of pages | 8 |
Journal | Thrombosis research |
Volume | 179 |
DOIs | |
State | Published - Jul 1 2019 |
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Keywords
- Anticoagulation
- Complications
- Extracorporeal membrane oxygenation
- Laboratory measures
- Pediatrics
ASJC Scopus subject areas
- Hematology
Cite this
Routine laboratory measures of heparin anticoagulation for children on extracorporeal membrane oxygenation : Systematic review and meta-analysis. / Padhya, D. P.; Prutsky, G. J.; Nemergut, M. E.; Schears, G. S.; Flick, Randall; Farah, W.; Wang, Zhen; Prokop, L. J.; Murad, Mohammad H; Alsawas, M.
In: Thrombosis research, Vol. 179, 01.07.2019, p. 132-139.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Routine laboratory measures of heparin anticoagulation for children on extracorporeal membrane oxygenation
T2 - Systematic review and meta-analysis
AU - Padhya, D. P.
AU - Prutsky, G. J.
AU - Nemergut, M. E.
AU - Schears, G. S.
AU - Flick, Randall
AU - Farah, W.
AU - Wang, Zhen
AU - Prokop, L. J.
AU - Murad, Mohammad H
AU - Alsawas, M.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: Specific protocols for anticoagulation for children on ECMO vary across institutions, with most using a continuous infusion of unfractionated heparin. The goal of this study is to aid clinician's decision on the best measure of heparin anticoagulation test; which would be the one that correlates well with heparin activity and helps in predicting hemorrhagic and thrombotic complications. Data sources: A comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus was conducted from each database's inception to 07/13/2018. Study selection: Studies evaluating children (<18 years)treated with ECMO and evaluating ACT, aPTT, TEG and Anti-Xa in any language were included. Data extraction: Two reviewers selected and appraised studies independently, and abstracted data. Results: We included 19 studies (759 patients, mean age 19.8 months). Meta-analysis showed strong correlation between heparin dosing and anti-Xa. Additionally, there was not a strong correlation between laboratory tests and complications (hemorrhagic and thrombosis), or mortality. Conclusion: Based on current evidence, Anti-Xa is the only laboratory test that shows strong correlation with heparin infusion dose and seems like the most suitable test for monitoring of anticoagulation with heparin in children on ECMO.
AB - Objective: Specific protocols for anticoagulation for children on ECMO vary across institutions, with most using a continuous infusion of unfractionated heparin. The goal of this study is to aid clinician's decision on the best measure of heparin anticoagulation test; which would be the one that correlates well with heparin activity and helps in predicting hemorrhagic and thrombotic complications. Data sources: A comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus was conducted from each database's inception to 07/13/2018. Study selection: Studies evaluating children (<18 years)treated with ECMO and evaluating ACT, aPTT, TEG and Anti-Xa in any language were included. Data extraction: Two reviewers selected and appraised studies independently, and abstracted data. Results: We included 19 studies (759 patients, mean age 19.8 months). Meta-analysis showed strong correlation between heparin dosing and anti-Xa. Additionally, there was not a strong correlation between laboratory tests and complications (hemorrhagic and thrombosis), or mortality. Conclusion: Based on current evidence, Anti-Xa is the only laboratory test that shows strong correlation with heparin infusion dose and seems like the most suitable test for monitoring of anticoagulation with heparin in children on ECMO.
KW - Anticoagulation
KW - Complications
KW - Extracorporeal membrane oxygenation
KW - Laboratory measures
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85066078924&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066078924&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2019.05.006
DO - 10.1016/j.thromres.2019.05.006
M3 - Review article
C2 - 31132667
AN - SCOPUS:85066078924
VL - 179
SP - 132
EP - 139
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
ER -