Coagulation Research in Paediatric ECMO: The Need for a Common Languagecoagulation Research in Paediatric ECMO: The Need for a Common Language

J. Drop^1,2, S. Van Den Helm³, E. Wildschut², R. Barton^3,4,5, H.P. Yaw^3,4, N. Letunica³, F. Newall^3,4,5, A. Johansen^6,7, D. Best^6,7, J. McKittrick⁶, G. MacLaren^3,6,8, S. Horton^4,9, R. Chiletti^6,7, W. Butt^4,6,7, Y. d'Udekem^4,9, C. van Ommen¹, V. Ignjatovic^3,4, P. Monagle^3,4,5

¹Erasmus University Medical Center - Sophia Children's Hospital Rotterdam, Department of Pediatric Haematology, Rotterdam, the Netherlands, ²Erasmus University Medical Center - Sophia Children’s Hospital Rotterdam, Pediatric Intensive Care Unit, Rotterdam, the Netherlands, ³Murdoch Children's Research Institute, Haematology Research, Melbourne, Australia, ⁴The Royal Children's Hospital, Department of Pediatrics, Melbourne, Australia, ⁵The Royal Children's Hospital, Department of Clinical Haematology, Melbourne, Australia, ⁶The Royal Children's Hospital, Department of Intensive Care, Melbourne, Australia, ⁷Murdoch Children's Research Institute, Pediatric Intensive Care Research Group, Melbourne, Australia, ⁸National University Health System, Cardiothoracic Intensive Care Unit, Singapore, Singapore, ⁹The Royal Children's Hospital, Department of Cardiac Surgery, Melbourne, Australia

Abstract Number: PB0285

Meeting: ISTH 2020 Congress

Theme: Coagulation and Natural Anticoagulants » Critical Care and Perioperative

Background: Extracorporeal membrane oxygenation (ECMO) involves complex coagulation management. Multicentre research is hampered by the fact that there are multiple variations to how each centre performs ECMO. Very few single centre publications include sufficient information about such variations to enable adequate comparison of results across studies. Hence, the applicability of any ECMO related research to other centres remains unclear. There is an urgent need to develop a common template of all ECMO and coagulation related variables to be documented clearly so that inter-study findings can be compared. The Extracorporeal Life Support Organization recently defined a mechanism for detailing exact cannulation techniques in a standard format. However, this is only one factor that impacts on coagulation research in ECMO.

Aims: To develop a common template of variables that are involved in coagulation management in paediatric ECMO patients so that studies can be compared across centres.

Methods: Two similar observational studies of coagulation parameters during ECMO in children are ongoing in Melbourne Australia (Royal Children’s Hospital) and Rotterdam, Netherlands
(Sophia Children’s Hospital). Each centre has independently developed their ECMO circuit set up and protocols. Sharing of data collection forms and database set up strategies, identified multiple discrepancies between circuit set up, management protocols, and definitions being used as research outcomes. An iterative process resolved many differences and agreed upon documentation techniques that enabled clear identification of remaining differences in analysis.

Results: Clinical parameters that required clear identification and research parameters that required consistency were identified and listed in Table 1.

Conclusions: ECMO research requires multicentre involvement to improve generalisability and enhance outcomes. This pilot demonstrates the approach that can be used to collaborate and improve comparability of research and results in the setting of ECMO.

To cite this abstract in AMA style:

Drop J, Van Den Helm S, Wildschut E, Barton R, Yaw HP, Letunica N, Newall F, Johansen A, Best D, McKittrick J, MacLaren G, Horton S, Chiletti R, Butt W, d'Udekem Y, van Ommen C, Ignjatovic V, Monagle P. Coagulation Research in Paediatric ECMO: The Need for a Common Languagecoagulation Research in Paediatric ECMO: The Need for a Common Language [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/coagulation-research-in-paediatric-ecmo-the-need-for-a-common-languagecoagulation-research-in-paediatric-ecmo-the-need-for-a-common-language/. Accessed October 1, 2023.

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