Anticoagulation and Renal Replacement Therapy in ECMO

Patient Management Considerations

• Proper management of anticoagulation is crucial when combining RRT and ECMO circuits, with the administration of heparin depending on patient factors, circuit set-up, and institutional protocols 1
• Continuous RRT is generally more appropriate than intermittent hemodialysis for ECMO patients due to their hemodynamic status 1
• Patients on ECMO are very sensitive to fluid overload, so earlier RRT initiation may be required for preventing and managing fluid overload compared to non-ECMO patients 2