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Carmeda surface heparinization in neonatal ECMO systems: long-term experiments in a sheep model

The thromboresistance in three Carmeda (Stockholm, Sweden) heparin- coated neonatal ECMO systems with a runtime of 45, 56 and 96 hours, respectively, and three noncoated systems with a runtime of 12, 42 and 66 hours, respectively, were compared using a sheep model. The flow rate was 200 ml/min and the activated clotting time (ACT) was kept at approximately 120 seconds. At the end of the experiment, the heparin-coated systems only contained minimal clotting while the controls showed major clotting in the entire system. Fibrin monomers were not detected until after 24 hours in the heparin- coated group, but demonstrated within 60 minutes in the noncoated group. It is concluded that the Carmeda heparin coating has a thromboresistant effect, and may be used to reduce the need for systemic heparinization in ECMO treatment of neonates.