{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:41:00Z","timestamp":1790181660891,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation (ECMO) plays an important role in providing temporary life support for patients with severe cardiac or pulmonary failure, but requires strict anticoagulation and monitoring. This network meta\u2010analysis systematically explored the most effective anticoagulation and monitoring strategies for patients receiving ECMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched up to January 31, 2023, for studies comparing unfractionated heparin (UFH), argatroban (Arg), bivalirudin (Biv), and\/or nafamostat mesylate (NM) in patients receiving ECMO. The primary outcomes included device\u2010related thrombosis, patient\u2010related thrombosis, and major bleeding events. The secondary outcomes included ECMO survival, ECMO duration, and in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2522 patients from 23 trials were included in the study. Biv was associated with a decreased risk of device\u2010related thrombosis (odd ratio [OR] 0.51, 95% confidence interval [CI]: 0.33\u20130.84) compared with UFH, whereas NM (OR 2.2, 95% CI: 0.24\u201365.0) and Arg (OR 0.92, 95% CI: 0.43\u20132.0) did not reduce the risk of device\u2010related thrombosis compared with UFH. Biv was superior to Arg in decreasing the risk of device\u2010related thrombosis (OR 0.14, 95% CI: 0.03\u20130.51). Biv reduced the risk of patient\u2010related thrombosis compared with UFH (OR 0.44, 95% CI: 0.18\u20130.85); NM (OR 0.65, 95% CI: 0.14\u20133.3) and Arg (OR 3.1, 95% CI: 0.94\u201312.0) did not decrease risk of patient\u2010related thrombosis compared with UFH. No significant difference was observed in the risk of major bleeding between three alternatives and UFH: Biv (OR 0.54, 95% CI: 0.23\u20131.3), Arg (OR 1.3, 95% CI: 0.34\u20135.8), and NM (OR 0.60, 95% CI: 0.13\u20132.6). NM showed a reduced risk of in\u2010hospital mortality compared with UFH (OR 0.27, 95% CI: 0.091\u20130.77), whereas Arg (OR 0.43, 95% CI: 0.15\u20131.2) and Biv (OR 0.75, 95% CI: 0.52\u20131.1) did not decrease risk of in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with UFH and Arg, Biv reduces the risk of thrombosis and appears to be a better choice for patients requiring ECMO. NM was associated with a reduced risk of in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2859","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T03:37:15Z","timestamp":1691120235000},"page":"1084-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Anticoagulation strategies in patients with extracorporeal membrane oxygenation: A network meta\u2010analysis and systematic review"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3959-6416","authenticated-orcid":false,"given":"Jiale","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Affiliated Jinhua Hospital Zhejiang University School of Medicine Jinhua 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