ReviewFrontiers in pediatrics2019
Anticoagulation in Neonatal ECMO: An Enigma Despite a Lot of Effort!
Review in Frontiers in pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- International treatment outcomes of neonates on extracorporeal membrane oxygenation (ECMO) with persistent pulmonary hypertension of the newborn (PPHN): a systematic review.Journal of cardiothoracic surgery · 2024Pooled it
- Neonatal extracorporeal membrane oxygenation in Colombia: outcomes, complication burden, and circuit-level constraints in a 15-year single-center cohort.Frontiers in pediatrics · 2026Article
- Severe cholestasis in neonatal extracorporeal membrane oxygenation.The journal of extra-corporeal technology · 2025Article
- Concurrent use of continuous kidney replacement therapy during extracorporeal membrane oxygenation: what pediatric nephrologists need to know-PCRRT-ICONIC practice points.Pediatric nephrology (Berlin, Germany) · 2025Review
- Viscoelastic coagulation testing in Neonatal Intensive Care Units: advantages and pitfalls in clinical practice.Blood transfusion = Trasfusione del sangue · 2023Review
- Predictors of intracranial hemorrhage in neonatal patients on extracorporeal membrane oxygenation.Scientific reports · 2023Observational
- Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis.Thrombosis and haemostasis · 2023Article
- Novel Coagulation Test Detects Anticoagulation Resistance and Is Associated With Thrombotic Events in Pediatric Patients Requiring Extracorporeal Membrane Oxygenation.Critical care explorations · 2022Article
- Eliminate Unnecessary Laboratory Work to Mitigate Iatrogenic Anemia and Reduce Cost for Patients on Extracorporeal Membrane Oxygenation.The journal of extra-corporeal technology · 2022Article
- Major Bleeding in Adults Undergoing Peripheral Extracorporeal Membrane Oxygenation (ECMO): Prognosis and Predictors.Critical care research and practice · 2022Article
- Hemostasis in neonatal ECMO.Frontiers in pediatrics · 2022Review
- Differential sialic acid content in adult and neonatal fibrinogen mediates differences in clot polymerization dynamics.Blood advances · 2021Article
- Neonatal respiratory and cardiac ECMO in Europe.European journal of pediatrics · 2021Review
- Neonatal coagulopathies: A review of established and emerging treatments.Experimental biology and medicine (Maywood, N.J.) · 2021Review
- Assessing Anticoagulation in Neonates With Congenital Diaphragmatic Hernia During Extracorporeal Membrane Oxygenation: Does Anti-Factor Xa or Thromboelastometry Provide Additional Benefit?Frontiers in pediatrics · 2021Article
- ECMO for Neonatal Sepsis in 2019.Frontiers in pediatrics · 2020Review
- Antithrombin Therapy: Current State and Future Outlook.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Use of Fresh-frozen Plasma in Newborn Infants.Newborn (Clarksville, Md.)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
Extracorporeal membrane oxygenation (ECMO) is a valuable modality used to support neonates, children, and adults with cardiorespiratory failure refractory to conventional therapy. It requires use of anticoagulation to prevent clotting in the extracorporeal circuit. Balancing bleeding from excessive anticoagulation with thrombotic risk remains a difficult aspect of ECMO care. Despite many advances in ECMO technology, better understanding of the coagulation cascade and new monitoring schemes to adjust anticoagulation, bleeding and thrombosis remain the most frequent complications in ECMO and are associated with morbidity and mortality. In neonates, ECMO is also complicated by the immature hemostatic system, laboratory testing norms which are not specific for neonates, lack of uniformity in management, and paucity of high-quality evidence to determine best practices. Traditional anticoagulation focuses on the use of unfractionated heparin. Direct thrombin inhibitors are also used but have not been well-studied in the neonatal ECMO population. Anticoagulation monitoring is complex and currently available assays do not take into account thrombin generation or platelet contribution to clot formation. Global assays may add valuable information to guide therapy. This review provides an overview of hemostatic alterations, anticoagulation, monitoring and management, novel anticoagulant use, and circuit modifications for neonatal ECMO. Future considerations are also presented.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.