LAUSR

Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy that has increasingly been used in recent years for the treatment of severe respiratory failure or cardiogenic shock, in the venovenous (VV) or veno-arterial (VA) configuration, respectively (1). ECMO is a complex procedure not without significant complications, including both thrombosis and bleeding. The use of an extracorporeal circuit for cardiopulmonary support exposes blood to non-biologic, thrombogenic surfaces, and for this reason, ECMO protocols recommend systemic anticoagulation. The presence of active bleeding or a high bleeding-risk scenario is a common occurrence in the typical critically ill, ECMO-candidate patient making the choice of the anticoagulation strategy very challenging.