OBJECTIVES:: To determine if a comprehensive extracorporeal membrane oxygenation anticoagulation monitoring protocol results in fewer @entity548 , reduced blood product usage, and increased circuit life. DESIGN:: In September 2011, we augmented our standard extracorporeal membrane oxygenation laboratory protocol to include anti-factor Xa assays, thromboelastography, and @entity5582 measurements. We performed a retrospective chart review to determine outcomes for @entity1 placed on extracorporeal membrane oxygenation prior to and after the initiation of our anticoagulation laboratory protocol. SETTING:: Tertiary care, academic @entity1 's hospital. @entity1 :: All @entity1 who were placed on extracorporeal membrane oxygenation at our institution from January 1, 2007, to September 30, 2013. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: There were 261 extracorporeal membrane oxygenation runs before the initiation of the protocol and 105 extracorporeal membrane oxygenation runs after the initiation of the protocol. There were no major changes to our extracorporeal membrane oxygenation circuit or changes to our transfusion threshold during the study period. The indication for extracorporeal membrane oxygenation, age, and severity of illness of the @entity1 were similar before and after protocol initiation. Median blood product usage for packed RBCs, fresh frozen plasma, platelets, and cryoprecipitate decreased significantly after protocol initiation. The occurrence of cannula site bleeding decreased from 22% to 12% (p = 0.04), and surgical site bleeding decreased from 38% to 25% (p = 0.02). Median extracorporeal membrane oxygenation circuit life increased from 3.6 to 4.3 days (p = 0.02). A trend toward increased @entity1 survival was noted, but it did not reach statistical significance. CONCLUSIONS:: We demonstrate an association between an extracorporeal membrane oxygenation anticoagulation laboratory protocol using anti-factor Xa assays, thromboelastography, and @entity5582 measurements and a decrease in blood product transfusion, a @entity548 , and an increase in circuit life. To our knowledge, this is the first study to demonstrate clinical benefit associated with the use of these laboratory values for @entity1 on extracorporeal membrane oxygenation.

The Use of an Extracorporeal Membrane Oxygenation Anticoagulation Laboratory Protocol Is Associated With Decreased Blood Product Use, XXXX , and Increased Circuit Life.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'PATIENTS'] @entity5582 :: ('462', 'Gene') :: ['antithrombin'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhagic complications', 'decrease in hemorrhagic complications']
@entity548 :: (MESH:D006470,Disease) :: ['Decreased Hemorrhagic Complications']
