ECMO anticoagulation: Are we monitoring precisely enough?

A recent international survey on anticoagulation practices in ECMO highlights significant variability in monitoring strategies.

While unfractionated heparin remains the standard, bivalirudin is now routinely used in over 50% of centers. Yet most institutions still rely heavily on aPTT — a test known to lack specificity in complex inflammatory and critical care states.

More specific assays for direct thrombin inhibitors (e.g., DTT/DTI) remain unavailable or slow to provide results. Viscoelastic testing is available in many centers — but rarely integrated into anticoagulation decision-making.

This variability reflects a broader challenge:

👉 We are increasingly using targeted anticoagulants, but not always pairing them with equally targeted monitoring. As ECMO care evolves, so must our diagnostic tools.

Multiclot offers the opportunity to provide more drug-specific, mechanism-driven insights — helping clinicians close the gap.

The future of ECMO anticoagulation isn’t just about the drug. It’s about monitoring it precisely. Access the article here