Evidence map›Paper›PMID 40081660›Full record

Trial reportChest2025

Low-Intensity vs Moderate-Intensity Anticoagulation for Venovenous Extracorporeal Membrane Oxygenation: The Strategies for Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation Pilot Trial.

Whitney D Gannon, Elias H Pratt, Melissa A Vogelsong, Wren H Adkisson, Matthew Bacchetta, Sarah L Bloom, Daniel J Ford, Brandon A Guenthart, Janna S Landsperger, Edward T Qian and 8 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04997265 (Strategies for Anticoagulation During Venovenous ECMO), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04997265 nacompletednot on this map

Strategies for Anticoagulation During Venovenous ECMO: The SAFE-ECMO Pilot Trial

TypeinterventionalSponsorVanderbilt University Medical CenterRan2022 to 2024Enrolled26ConditionsAcute Hypoxemic Respiratory Failure, Anticoagulant-induced Bleeding, ThromboembolismArmsLow intensity anticoagulation, Moderate Intensity Anticoagulation
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Whitney D GannonDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN. Electronic address: whitney.gannon@vumc.org.
Elias H PrattDivision of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC.
Melissa A VogelsongDivision of Cardiac Anesthesia, Department of Anesthesiology, Stanford University, Stanford, CA.
Wren H AdkissonDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Matthew BacchettaDepartment of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN.
Sarah L BloomDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Daniel J FordDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Brandon A GuenthartDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA.
Janna S LandspergerDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Edward T QianDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Craig R RackleyDivision of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC.
Todd W RiceDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Vikram Fielding-SinghDivision of Cardiac Anesthesia, Department of Anesthesiology, Stanford University, Stanford, CA.
John W StokesDepartment of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Joanna L StollingsDepartment of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN.
Matthew W SemlerDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Jonathan D CaseyDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Pragmatic Critical Care Research Group

Funding

Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Bag-Mask Ventilation to PreVent Hypoxemia during Tracheal Intubation in the Emergency Department: A Clinical TrialK23HL153584 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CASEY, JONATHAN DALE · 2020 to 2024
$900k
Toward optimizing dialysis in the perioperative periodK23DK138312 · NIDDK · STANFORD UNIVERSITY · PI Vikram Fielding-Singh · 2024 to 2026
$496k
American Heart Association-American Stroke Association 23CDA1053913NHLBI NIH HHS K23 HL153584NHLBI NIH HHS T32 HL087738NIDDK NIH HHS K23 DK138312
6 · The paper itself

Abstract

backgroundBleeding is a common and sometimes fatal complication of venovenous extracorporeal membrane oxygenation (ECMO). Whether lowering the intensity of anticoagulation during venovenous ECMO is safe or effective is unknown. RESEARCH QUESTION: Is a large, multicenter randomized trial of low-intensity vs moderate-intensity anticoagulation during venovenous ECMO feasible? STUDY DESIGN AND

methodsIn a multicenter, parallel-group, randomized pilot trial conducted at 3 centers across the United States, we randomly assigned critically ill adults undergoing venovenous ECMO to low-intensity or moderate-intensity anticoagulation. Feasibility was assessed by enrollment rate and adherence to the assigned anticoagulation strategy. The primary efficacy outcome was major bleeding, and the primary safety outcome was thromboembolic events, both assessed between enrollment and 24 hours after decannulation.

resultsAll of the 26 patients enrolled received the assigned intensity of anticoagulation. A major bleeding event occurred in 1 of 12 patients (8.3%) in the low-intensity anticoagulation group and in 4 of 14 patients (28.6%) in the moderate-intensity anticoagulation group (absolute risk difference, -20.2 percentage points; 95% CI, -48.6 to 8.1; P = .33). One patient experienced a thromboembolic event (8.3%) in the low-intensity anticoagulation group compared with none in the moderate-intensity group (difference, 8.3 percentage points; 95% CI, -7.3 to 24.0; P = .46). No patients died before discharge in the low-intensity anticoagulation group, compared with 2 patients (14.3%) in the moderate-intensity group, both of whom experienced major bleeding events. No patients died before discharge in the low-intensity anticoagulation group, compared with 2 patients (14.3%) in the moderate-intensity group, both of whom experienced major bleeding events.

interpretationOur results indicate that enrollment and separation between groups are feasible in a multicenter randomized trial of low-intensity vs moderate-intensity anticoagulation for critically ill adults receiving venovenous ECMO. A large, multicenter, randomized trial is needed and seems to be feasible. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT04997265; URL: www. CLINICALTRIALS: gov.

Indexed as

AnticoagulantsExtracorporeal Membrane OxygenationHemorrhageThromboembolismAdultCritical IllnessFemaleHumansMaleMiddle AgedPilot ProjectsTreatment OutcomeUnited StatesAnticoagulantsacute respiratory failureanticoagulationARDScritical careextracorporeal membrane oxygenation

Identifiers

PMID40081660
PMCPMC12489345

What OpenQuestion holds

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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.