VV-ECMO without anticoagulation in trauma patients: balancing bleeding and thrombosis - Summary - MDSpire

VV-ECMO without anticoagulation in trauma patients: balancing bleeding and thrombosis

  • By

  • Jingyi Wu

  • Yu Gan

  • Hongbin Hu

  • Lihan Shen

  • Zhenhua Zeng

  • May 17, 2026

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Objective:

To evaluate the feasibility and outcomes of VV-ECMO without systemic anticoagulation in trauma patients with severe hypoxemic respiratory failure.

Key Findings:
  • Median age of patients was 47 years, with 78.6% male.
  • Median duration of VV-ECMO support was 227.3 hours.
  • Thrombotic complications included oxygenator thrombosis in 14.3% and deep vein thrombosis in 35.7% of patients.
  • Major bleeding occurred in 28.6% of patients, but no catastrophic bleeding was linked to the absence of anticoagulation.
  • ICU mortality was 21.4% and 28-day survival was 78.6%.
Interpretation:

VV-ECMO without systemic anticoagulation may be a viable option for selected trauma patients, balancing the risks of bleeding and thrombosis with careful monitoring.

Limitations:
  • Small sample size of 14 patients limits generalizability.
  • Observations are based on a single-center experience.
Conclusion:

The study suggests that VV-ECMO without anticoagulation can be considered in carefully selected trauma patients, with close monitoring to manage potential complications.

Original Source(s)

VV-ECMO without anticoagulation in trauma patients: balancing bleeding and thrombosis

  • by Jingyi Wu, Yu Gan, Hongbin Hu, Lihan Shen, Zhenhua Zeng

  • May 17, 2026

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