{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:55:44Z","timestamp":1781067344253,"version":"3.54.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hemophilia of Georgia Clinical Scientist Development Grant"},{"name":"Children\u2019s Foundation","award":["R1-2023-58"],"award-info":[{"award-number":["R1-2023-58"]}]},{"name":"Children\u2019s Foundation","award":["R1-2022-71"],"award-info":[{"award-number":["R1-2022-71"]}]},{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013995","name":"Sanofi Genzyme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016471","name":"Agios Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016471","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004328","name":"Genentech","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004328","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anticoagulation in pediatric extracorporeal membrane oxygenation (ECMO) presents unique challenges due to developmental hemostasis, coagulation factor production, and response to anticoagulants. This process requires close monitoring to prevent bleeding and thrombotic events. Limited data exist on how traditional coagulation tests correlate with these complications in this population in the first 24\u00a0h after ECMO cannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This institutional review board-approved retrospective review was conducted on 126 children requiring ECMO between January 2017 and March 2022. Pre- and post-cannulation partial thromboplastin time (PTT), prothrombin time (PT), international normalized ratio (INR), hemoglobin, platelet count, and fibrinogen were collected. Also measured were initial activated clotting time (ACT), time to reach target ACT post-heparin bolus (\u2264250\u00a0s), initial unfractionated heparin (UFH) infusion rate, and post-cannulation antithrombin III activity (ATIII).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to those who did not experience complications, patients who experienced bleeds showed a longer time until target ACT was reached (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.003), prolonged post-cannulation PT and INR (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002 for both), lower pre- and post-cannulation fibrinogen levels (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008 and\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = &lt;0.001, respectively), and lower post-cannulation platelet counts (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.035). However, those who experienced thrombotic complications showed only higher pre-cannulation fibrinogen levels (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data shows that fibrinogen is an important parameter which defines the risk of early bleeding or thrombotic complications during the first 24 hours of ECMO cannulation. Attention to these baseline and immediate post-cannulation laboratory values may be important to determine initial bolus dosing and adjustment of anticoagulation in these patients. Continued multi-center collaboration to determine the utility of incorporation of other coagulation studies, like anti-factor Xa and viscoelastic assays, is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251335592","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T09:20:44Z","timestamp":1744622444000},"page":"1837-1846","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Navigating coagulation: Key markers in the first 24 hours of pediatric ECMO"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7989-8150","authenticated-orcid":false,"given":"Jan V","family":"Stevens","sequence":"first","affiliation":[{"name":"Wayne State University\/Children\u2019s Hospital of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Regling","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Michigan\/Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elika","family":"Ridelman","sequence":"additional","affiliation":[{"name":"Wayne State University\/Children\u2019s Hospital of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Chitlur","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Michigan\/Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Michelle Veenstra","sequence":"additional","affiliation":[{"name":"Wayne State University\/Children\u2019s Hospital of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Shanti","sequence":"additional","affiliation":[{"name":"Wayne State University\/Children\u2019s Hospital of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001630"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.988681"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1606179"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001652"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/pediatric14030039"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2019.05.006"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.02.014"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002696"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e318279854a"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1756704"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/neo.23-2-e82"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12531"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14800"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ec173d"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003488"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003489"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659117720494"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-014-0064-1"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000993"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.5863\/1551-6776-27.6.517"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2022.01.009"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248720"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003492"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2024.109134"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11175147"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-20-1515"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40635-019-0264-z"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251335592","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591251335592","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251335592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:35:55Z","timestamp":1777656955000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591251335592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/02676591251335592"],"URL":"https:\/\/doi.org\/10.1177\/02676591251335592","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]}}}