Anticoagulation during Extracorporeal Membrane Oxygenation (ECMO)

Gandini, L., de Veer, S., Chan, C., Passmore, M., Liu, K., Lundon, B., Rachakonda, R., White, N., Rhodes, M., Shanahan, E., Yap, K., See Hoe, L., Semenzin, C., Li Bassi, G., Fraser, J., Craik, D., Suen, J. American Chemical Society DOI: 10.1021/acsptsci.4c00352

Abstract: Extracorporeal membrane oxygenation (ECMO) is a form of life support for critically ill patients with severe respiratory or cardiac failure. Interactions between patient blood and ECMO biomaterials increase the risk of thrombosis, necessitating concurrent anticoagulation treatment, with the standard of care being heparin. However, hemostatic complications such as thrombosis and bleeding remain prevalent. Activated factor XII (FXIIa) inhibitors are selective anticoagulants and offer a potential alternative to heparin. We aimed to evaluate the efficacy of IMB-F12, a cyclotide-based FXIIa inhibitor, in human blood using an ex vivo ECMO model.