Anticoagulation and hemostasis in the extracorporeal membrane oxygenation patient

Hemostatic disturbances during ECMO reflect a complex interplay between patient severity, circuit-related shear stress, and systemic anticoagulation. Understanding these mechanisms is key to preventing both bleeding and thrombosis. Standardization of monitoring and the development of personalized, physiology-based anticoagulation protocols, supported by emerging technologies and more biocompatible circuits, represent the next step toward improving outcomes in ECMO-supported patients.