{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:18:28Z","timestamp":1793643508975,"version":"4.5.1"},"reference-count":15,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Background: Monitoring the anticoagulant effect of unfractionated heparin (UFH) in extracorporeal membrane oxygenation (ECMO) patients is complex but critically important to balance the risks of treatment related bleeding and circuit thrombosis. While guidelines recommend using more than one method to monitor UFH activity, the use of thromboelastometry (ROTEM) to monitor UFH in ECMO patients has not been investigated in detail.<\/jats:p>\n                  <jats:p>Methods: This is an observational, single-center retrospective study looking at adult ECMO patients on UFH that had ROTEM and thromboelastography (TEG) tests obtained concurrently. A total of 20 samples were obtained from nine patients during the study period, seven of which were on veno-arterial (VA) ECMO and two of which were on veno-venous (VV) ECMO.<\/jats:p>\n                  <jats:p>Results: Under institutional standard operating practice, when TEG and\/or activated partial thromboplastin time (aPTT) were considered therapeutic, intrinsic thromboelastometry clotting time (INTEM CT) was only 1.2 times higher than the normal range. TEG based monitoring compared to aPTT based monitoring tended to result in lower anti-Xa levels and less intensive anticoagulation. For the total cohort, bleeding events, driven by the need for blood transfusions, were more common compared to ischemic events (77% vs 11%; p = 0.02).<\/jats:p>\n                  <jats:p>Conclusion: INTEM CT tended to be less sensitive to lower doses of UFH with a value of 1.2 times higher than the normal range when aPTT and\/or TEG were considered therapeutic. Due to the relative insensitivity of ROTEM, our institution decided to continue to use TEG instead of ROTEM. Larger, multicenter trials may be helpful to validate these findings.<\/jats:p>","DOI":"10.1177\/02676591241232513","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T01:47:51Z","timestamp":1708480071000},"page":"235-242","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Thromboelastography versus thromboelastometry for unfractionated heparin monitoring in adult patients on extracorporeal membrane oxygenation"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-0775","authenticated-orcid":false,"given":"Ellen B","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Baylor St. Luke\u2019s Medical Center, Houston, TX, USA"},{"name":"Department of Pharmacy, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur W","family":"Bracey","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA"},{"name":"Department of Cardiovascular Pathology, Texas Heart Institute, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhasis","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Department of Surgery, Divisions of General and Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"bibr1-02676591241232513","unstructured":"The Extracorporeal Life Support Organization (ELSO). Extracorporeal Life support organization (ELSO) general guidelines for all ECLS cases. Available online https:\/\/www.elso.org\/Portals\/0\/Files\/elsoanticoagulationguideline8-2014-table-contents.pdf, (Accessed 15 January 2024)."},{"key":"bibr2-02676591241232513","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.08.44"},{"key":"bibr3-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-017-0352-8"},{"key":"bibr4-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000325"},{"key":"bibr5-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001196"},{"key":"bibr6-02676591241232513","unstructured":"Calatzis A, Gorlinger K, Spannagl M, et al. ROTEM analysis targeted treatment of acute haemostatic disorders. Available online https:\/\/www.ttuhsc.edu\/medicine\/odessa\/internal\/documents\/ttim-manual\/ROTEM_Analysis.pdf, (Accessed 15 January 2024)."},{"key":"bibr7-02676591241232513","unstructured":"Taylor J, Cotton B. Coagulation issues and the trauma patient. 13th edition. Philadelphia, PA: Current Surgical Therapy, 2020, pp. 1251\u20131259."},{"key":"bibr8-02676591241232513","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11175147"},{"key":"bibr9-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001652"},{"key":"bibr10-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003780"},{"key":"bibr11-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000475"},{"key":"bibr12-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)01792-1"},{"key":"bibr13-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12737"},{"key":"bibr14-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.02.011"},{"key":"bibr15-02676591241232513","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1604400113"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241232513","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591241232513","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241232513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:34:14Z","timestamp":1777656854000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591241232513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,20]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1177\/02676591241232513"],"URL":"https:\/\/doi.org\/10.1177\/02676591241232513","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,20]]}}}