- 1Pedaitrics, Sophia Children's Hospital, Netherlands
- 2Pedaitric Hematology, Columbia University, United States
- 3Pediatrics, Wayne State University School of Medicine, United States
- 4Pediatrics, Children's Hospital of Michigan, United States
Extracorporeal membrane oxygenation (ECMO) is becoming increasingly utilized to manage neonates with cardiac and respiratory failure. The procedure involves extensive anticoagulation in a sick neonate with underlying disease pathology. In addition, the immature hemostatic system in the neonate adds to the complexity of titrating the necessary anticoagulation. This places the infant at greater risk for life threatening hemorrhage and thrombosis. Managing anticoagulation in these infants is extremely challenging and needs the expertise of a physician with a thorough knowledge of the intricacies of developmental hemostasis and limitations of the current laboratory techniques available to manage anticoagulation. This article provides a brief overview of the developing hemostatic system of the neonate and the challenges associated with managing anticoagulation in this vulnerable population of patients.
Keywords: neonate, ECMO, anticoagulation, Monitoring, complications
Received: 03 Jun 2018;
Accepted: 21 Sep 2018.
Edited by:Jun Teruya, Texas Children's Hospital, United States
Reviewed by:Brian R. Branchford, School of Medicine, University of Colorado, United States
Jonas Emsley, University of Nottingham, United Kingdom
Copyright: © 2018 Van Ommen, Neunert and Chitlur. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Meera B. Chitlur, MD., Wayne State University School of Medicine, Pediatrics, Detroit, 48201, Michigan, United States, firstname.lastname@example.org