ReviewFrontiers in medicine2023
Is it time to switch to bivalirudin for ECMO anticoagulation?
Review in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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
7 citing papers in PubMed, 13 citations in OpenAlex.
- Considerations and future challenges in managing ECMO for pediatric patients.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Review
- Extracorporeal Membrane Oxygenation in Refractory Cardiac Arrest: Current Evidence, Clinical Pathways and Future Directions.Life (Basel, Switzerland) · 2026Review
- Alternate and Emerging Anticoagulation Strategies for Extracorporeal Membrane Oxygenation: A Scoping Review.Journal of clinical medicine · 2026Review
- From Pandemic to Practice: How COVID-19 Has Reshaped Haemostasis in Cardiac Surgery: A Narrative Review.Journal of clinical medicine · 2025Review
- Alternative Anticoagulation for Patients with Heparin-Induced Thrombocytopenia on ECMO: A Narrative Review.Biomedicines · 2025Review
- Hirudin in the Treatment of Chronic Kidney Disease.Molecules (Basel, Switzerland) · 2024Review
- Ventilatory Management of Patients with Acute Respiratory Distress Syndrome Due to SARS-CoV-2.Journal of clinical medicine · 2023Review
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
No grant is acknowledged in the PubMed record.
Abstract
For decades, unfractionated heparin (hereafter, heparin) has been the primary anticoagulant used for extracorporeal membrane oxygenation (ECMO) support. More recently, however, bivalirudin, a direct thrombin inhibitor, has emerged as an alternative. This systematic review based on PRISMA guidelines, aims to summarize 16 comparative studies and 8 meta-analysis and review articles published from January, 2011 till May, 2023 which directly compares ECMO courses using heparin versus bivalirudin as the anticoagulant. While this comparison is complicated by the lack of a standardized definition of major bleeding or thrombosis, our overall findings suggest there is no statistical difference between heparin and bivalirudin in incidence of bleeding and thrombosis. That said, some studies found a statistical significance favoring bivalirudin in reducing major bleeding, thrombosis, and the need for transfusions. We also offer essential guidance for appropriately selecting an anticoagulant and monitoring its effect in ECMO settings.
Indexed as
Identifiers
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.