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Semin Thromb Hemost 2020; 46(03): 357-365
DOI: 10.1055/s-0040-1708542
Review Article

Platelet Count and Function during Pediatric Extracorporeal Membrane Oxygenation

Katherine Cashen
1   Department of Pediatrics, Division of Critical Care Medicine, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
,
Kathleen Meert
1   Department of Pediatrics, Division of Critical Care Medicine, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
,
Heidi J. Dalton
2   Department of Pediatrics, Division of Critical Care Medicine, INOVA Heart and Vascular Institute, Inova Fairfax Medical Institute, Falls Church, Virginia
3   George Washington University, Washington, Dist. of Columbia
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Abstract

Extracorporeal membrane oxygenation (ECMO) is a form of life support used to treat neonates, children, and adults with cardiorespiratory failure refractory to conventional therapy. This therapy requires the use of anticoagulation to prevent clotting in the extracorporeal circuit, but anticoagulation also increases the risk of bleeding on ECMO. Both bleeding and thrombosis remain significant complications on ECMO and balancing these risks is challenging. Acquired platelet dysfunction is common during ECMO and quantitative and qualitative platelet dysfunction contributes to bleeding risk. Optimal platelet count, function, and transfusion thresholds are not well established during pediatric ECMO. In this review, we provide an overview of hemostatic alterations during ECMO, changes in platelet count and function, platelet monitoring techniques, bleeding risk, and future needs to best optimize patient management and care.

Keywords

extracorporeal membrane oxygenation - platelets - platelet function - thrombosis - bleeding


Publication History

Publication Date:
31 March 2020 (online)

© 2020. Thieme. All rights reserved.

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