Algorithm-based management of bleeding in patients with extracorporeal membrane oxygenation
© BioMed Central Ltd 2013
Published: 8 May 2013
We read with interest the paper published by Repressé and colleagues . Coagulation management is a challenge during extracorporeal membrane oxygenation (ECMO) due to complex hemostatic and inflammatory responses associated with the underlying conditions that include infection, sepsis, surgery, and/or traumatic injury . Repressé and colleagues present the first algorithm-based approach to bleeding in ECMO patients. However, additional perspectives are important to consider.
Second, adverse events including 32% venous thrombosis and a 2.5% incidence of fatal pulmonary embolism have already been reported in ECMO patients . In another series, Combes and colleagues reported a 10% incidence of femoral vein and 7% incidence vena cava thrombosis . Recombinant activated factor VII is associated with thromboembolic events  and should be used with caution until additional data help us evaluate the benefit-to-risk administration in bleeding ECMO patients.
extracorporeal membrane oxygenation
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