Abstract: Extracorporeal membrane oxygenation（ECMO） has become a critical and essential technology in adult and pediatric intensive care units and is the ultimate treatment for severe respiratory and/or circulatory failure. Complications related to the coagulation system such as bleeding and thrombosis during ECMO are one of the main factors affecting the mortality of patients. There is no unified standard on the best anticoagulant strategy for ECMO. This paper reviews the research progress of anticoagulation management and monitoring methods during ECMO in children，and discusses how to achieve the best anticoagulation management during ECMO.

Key words: ECMO, pediatric, anticoagulation, anti-Xa, direct thrombin inhibitors

摘要： 体外膜氧合（ECMO）技术已经成为成人及儿童重症监护病房必不可少的关键技术，是严重呼吸衰竭和（或）循环衰竭的终极治疗手段。ECMO期间出血及血栓等凝血系统并发症是影响患者死亡的主要因素之一。目前关于ECMO的最佳抗凝策略尚无统一标准。该文就儿童ECMO期间的抗凝药物及监测方法进行讨论，探讨如何把ECMO期间的抗凝管理做到最佳。

关键词: 体外膜氧合, 儿科, 抗凝, 抗Xa, 直接凝血酶抑制剂