Coagulation, anticoagulation, and inflammatory response

Abstract

Extracorporeal membrane oxygenation (ECMO) represents a modified system of cardiopulmonary bypass (CPB). Depending on the type of cannulation, it may assist or replace both the cardiac and the pulmonary function (arteriovenous ECMO) or the pulmonary function alone (venovenous ECMO). Regardless of this difference, the ECMO circuit always includes a centrifugal pump, tubings, and an oxygenator. To this respect, the pathophysiological reactions of blood coming in contact with foreign surfaces are similar to those observed during CPB. However, major differences exist between CPB and ECMO, with different degrees of hemostasis and coagulation and inflammatory reactions.