Anticoagulation-related complications 
Unfractionated heparin is often used for anticoagulation to keep the circulatory system patent to prevent thrombosis formation in the extracorporeal circulation and the patient’s circulatory system. Thankfully current ECMO circuits have almost no possibility of thrombus formation. Haemolysis can also occur especially if a thrombus forms in the pump causing mechanical damage to cells resulting in haemolytic anaemia. Heparin-induced thrombocytopenia could also be a cause of clot formation. Intracranial haemorrhage is also a possibility in ECMO patients from excess infusion of anticoagulation and early correction of thrombocytopenia may help reduce risks of occurrence. Other neurological complications such as strokes and cognitive impairment could also result if haemostatic balance is not well controlled.
D-dimers can be monitored daily to look out for any clot formation and to anticipate eminent ECMO failure. Before ECMO initiation, patients should be tested for any coagulation disorders by measuring parameters such as antithrombin and fibrinogen levels, which can be corrected to prevent further complications.