What should be monitored to prevent clotting in the ECMO circuit?

Monitoring transmembrane pressure trends is crucial in preventing clotting within the ECMO circuit. Transmembrane pressure reflects the resistance to blood flow through the membrane oxygenator, and an increase in this pressure often indicates that the circuit is becoming obstructed, possibly by the formation of clots. By keeping a close watch on these trends, clinicians can identify when the circuit may be at risk and take preemptive measures, such as adjusting anticoagulation therapy or modifying the circuit flow rate, to mitigate the risk of clot formation.

In comparison, cannula size is important for ensuring adequate blood flow and minimizing shear stress but does not directly provide information about clotting within the circuit. Monitoring the patient’s respiratory rate and ventilator settings focuses on the patient’s respiratory support rather than the ECMO circuit's integrity or function. Consequently, these aspects are not directly relevant to preventing clotting in the ECMO system.