What type of anticoagulation is most commonly used during ECMO?

During ECMO, heparin is the most commonly used anticoagulant because it has properties that suit the needs of patients undergoing this complex therapy. Heparin is a fast-acting, reversible anticoagulant, which is crucial in the ECMO setting where immediate anticoagulation is required to prevent thrombus formation within the ECMO circuit.

Moreover, heparin can be administered intravenously, allowing for quick adjustments to dosing based on the patient's coagulation status, which is monitored through activated partial thromboplastin time (aPTT) or anti-factor Xa levels. This ability to rapidly modify anticoagulation strategies is essential, as patients on ECMO often have variable responses to anticoagulation due to factors such as changes in hemodynamics or variations in blood flow within the circuit.

In contrast, other options like warfarin, aspirin, and direct oral anticoagulants are not ideal for ECMO management. Warfarin is a long-acting oral anticoagulant that requires several days to reach therapeutic levels and cannot be easily reversed in acute situations. Aspirin is primarily an antiplatelet agent and does not provide adequate anticoagulation for the ECMO circuit. Direct oral anticoagulants are not typically used in