Dr. Kai-Man CHAN
Consultant in-charge of ICU, Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
Dr Chan Kai Man is our colleague coordinating the ECMO services in NTEC. He had a special interest in cardiac ECMO therapies in adult ICU, in particular, weaning strategies from ECMO, haemolysis complication and simulation training related to ECMO therapy.
The pathophysiology of blood and non-biologic contact is complex and involves the close linkage of cellular, coagulation cascade and complement pathways. Haemolysis arise during ECMO run also play a role in the procoagulant state. The current practice of monitoring of anticoagulation, patient’s coagulation status and the variations in transfusion are not evidence based, understanding the principles underlying the rationale for each modality of monitoring is important.
While data regarding haemostatic agents is scarce, haemostatic management should follow an escalation pyramid, and be closely monitored, preferably by dynamic point of care test.