Activated partial thromboplastin time (aPTT)-guided anticoagulation monitoring during extracorporeal membrane oxygenation (ECMO) support: A systematic review and meta-analysis
Authors' conclusion
We did not find strong evidence supporting the aPTT-guided monitoring during ECMO.
Study context
- Population
- Patients on ECMO support receiving systemic anticoagulation
- Participants
- 3,249 patients · 17 studies
- Comparison
- Patients with vs without hemorrhage during ECMO; aPTT-guided anticoagulation monitoring and bleeding
- Outcome
- Association of anticoagulation monitoring (aPTT) with bleeding during ECMO support
Methodological detailsPRISMA-compliant
- PRISMA-compliant
Pooled result
As reported in the abstract
Association of aPTT with bleeding
- Patients with hemorrhage had longer aPTT, longer ECMO duration and higher mortality
- No strong evidence of any aPTT threshold association with bleeding; less than half of authors reported a potential relationship
Further pooled results
Mortality (did not survive to discharge)
- Almost one-half of patients did not survive to discharge
- 47%, 1192/2490
Characteristics of patients experiencing hemorrhage
- Patients with hemorrhage had longer aPTT, longer ECMO duration and higher mortality
Safety
AKI (most frequent adverse event)
- AKI
- 66%, 233/356
Hemorrhage (adverse event)
- Hemorrhage
- 46%, 469/1046
Original publication
aPTT-guided anticoagulation monitoring during ECMO support: A systematic review and meta-analysis. J Crit Care. Published 25 May 2023. doi:10.
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