Rogerson, Colin M.Hobson, Michael J.2023-10-022023-10-022022Rogerson CM, Hobson MJ. The Heparin-Antithrombin Product: A Novel Value for Pediatric Extracorporeal Anticoagulation. J Extra Corpor Technol. 2022;54(2):115-122. doi:10.1182/ject-115-122https://hdl.handle.net/1805/35916Hematologic complications are a source of morbidity and mortality for patients receiving extracorporeal membrane oxygenation (ECMO) support. There is no consensus strategy for monitoring anticoagulation for children supported with ECMO. This study evaluated a novel measurement of anticoagulation for children on ECMO. This was a single-center observational study of children supported with ECMO from 2015 to 2020. Each patient’s current unfractionated heparin dose was multiplied by the current antithrombin III (AT) level to obtain a novel anticoagulation value, the heparin-antithrombin product (HAP). This value was compared with the heparin dose, AT, and activated clotting time (ACT) to predict anti-Xa value using linear correlation and decision tree methods. Data were obtained from 128 patients supported with ECMO. The HAP value was more highly correlated with anti-Xa level than heparin dose, AT level, and ACT. This correlation was highest in the neonatal population (r = .7). The variable importance metrics from the regression tree and random forest models both identified the HAP value as the most influential predictor variable for anti-Xa value. The HAP value is more highly correlated with the anti-Xa level than heparin dose, AT level, or ACT. Further research is needed to evaluate the effectiveness of the HAP value as a measurement of anticoagulation for children on ECMO.en-USPublisher PolicyExtracorporeal membrane oxygenationAnticoagulationPediatricsCritical care medicineArticle