ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
The relationship between different anticoagulation monitoring indicators and heparin doses in adult patients with extracorporeal cardiopulmonary resuscitation
Provisionally accepted
- 1Jinhua Central Hospital, Jinhua, China
- 2Shengli Clinical Medical College of Fujian Medical University, fuzhou, China
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Objectives: Achieving optimal systemic anticoagulation in patients undergoing extracorporeal membrane oxygenation (ECMO) requires precise titration, posing a significant clinical challenge. This study aims to explore the relationship between various anticoagulation monitoring parameters and heparin dosing in adult patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR). Methods: A retrospective analysis was conducted on 40 ECPR patients, who were categorized into either the activated clotting time (ACT)-target group or the activated partial thromboplastin time (aPTT)-target group. Anticoagulation monitoring parameters, including aPTT, corresponding ACT, and heparin doses, were collected. Continuous variables are expressed as mean ± SD and compared using Student's t-test. Pearson correlation analysis was performed to examine the relationships between ACT, aPTT, and heparin doses in both groups. Results: Of the 40 patients, 16 (40%) died and 24 (60%) survived. Twelve patients (30%) experienced severe bleeding events, while 5 (12.5%) developed thrombotic complications. Compared to the ACT-target group, the aPTT-target group had higher platelet counts (PLT) and lower blood flow levels (P < 0.001). Pearson correlation analysis revealed that heparin dose was positively correlated with aPTT (r = 0.412, P < 0.001) and negatively correlated with blood flow (r = -0.329, P < 0.001). ACT showed a weak correlation with aPTT (r = 0.123, P < 0.001). Conclusion: Heparin dosing exhibited a stronger correlation with aPTT than with ACT, and blood flow emerged as an important monitoring parameter. Comprehensive anticoagulation monitoring strategies should be employed to evaluate heparin efficacy in ECMO-treated ECPR patients.
Keywords: Extracorporeal Membrane Oxygenation, Heparin, activated clotting time, activatedpartial thromboplastin timesepsis, Anticoagualant
Received: 25 Jun 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 YAO, Jin, Du and Yu. 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) or licensor 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:
Jiali YAO, 1596774927@qq.com
Huizhen Yu, yhz200333@fjmu.edu.cn
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