Lansink-Hartgring et al reported risk factors for hemorrhage during extracorporeal membrane oxygenation (ECMO). These can help to identify a patient who may require more aggressive management. The authors are from University of Groningen in The Netherlands.

Patient selection: adult on ECMO


Outcome: hemorrhagic complications (surgical site, cannula site, gastrointestinal, pulmonary, intracranial, other)


Unfractionated heparin was the anticoagulant used. An alternative anticoagulant might not impact the aPTT.


Risk factors:

(1) elevated aPTT in the 24 hours prior to hemorrhage (HR 1.14 per 10 second increase)

(2) venoarterial ECMO (HR 2.89)

(3) duration of ECMO support (HR 0.97 per day)


Additional risk factors:

(1) platelet count (HR 0.97 per 10 * 10^9/L)

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