Heparin Exposure Adjustment to Reduce Thrombo-hemorrhagic Complications After Venoarterial Extracorporeal Membrane Oxygenator Cannulation: The HEART-ECMO Observational Cohort Study
Authors' conclusion
Withholding the UFH bolus during VA-ECMO cannulation results in comparable postimplantation activated partial thromboplastin time values and may reduce early bleeding without increasing thrombotic complications.
Study context
- Population
- Adults undergoing emergent peripheral venoarterial extracorporeal membrane oxygenator (VA-ECMO) (cardiogenic shock, ECPR)2,020–2024
- Participants
- 59 adults
- Exposure
- No unfractionated heparin (UFH) bolus vs UFH bolus at emergent peripheral VA-ECMO cannulation
- Outcome
- Activated partial thromboplastin time within therapeutic range
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
P = 0.776
Observational data: associations, not effects.
Safety
Major bleeding (Bleeding Academic Research Consortium classification ≥3) · first 24 hours
RBC transfusions
P = 0.003
- Major bleeding (Bleeding Academic Research Consortium classification ≥3) — Multivariate analysis showed similar trends (aOR)
- 2.26; p = 0.311
Thrombotic events
- Thrombotic event rates similar between groups (bolus v nonbolus)
- 14.3% v 16.7%; p = 0.803
- No device-related thrombosis observed
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Heparin Exposure Adjustment to Reduce Thrombo-hemorrhagic Complications After Venoarterial Extracorporeal Membrane Oxygenator Cannulation: The HEART-ECMO Observational Cohort Study. J Cardiothorac Vasc Anesth. Published 21 January 2026. doi:10.
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