# Pediatric ECMO Anticoagulation Collaborative (PEACE) Consensus

> **NIH NIH R13** · BOSTON CHILDREN'S HOSPITAL · 2021 · $74,880

## Abstract

Abstract
Extracorporeal Membrane Oxygenation (ECMO) provides support for critically ill patients with heart and/or lung
failure unresponsive to other therapies. The complexities of this invasive technique require coordinated,
multidisciplinary patient care among critical care medicine, surgical specialties, cardiology, hematology,
transfusion medicine, pharmacy, specialized bedside nursing, and perfusion or ECMO-specialized respiratory
therapists. ECMO use in children has increased considerably over the past 20 years, expanding to broader
indications and increasingly complex patients. In 2018, almost 3,500 critically ill infants and children were
supported with ECMO, with mortality rates as high as 40-50%. Infants and children on ECMO require
therapeutic anticoagulation to maintain patency of the ECMO circuit. There are few high-quality data to guide
anticoagulation management resulting in high practice variation. Bleeding and clotting remain among the most
common, often fatal, ECMO-associated complications. There is a critical need to develop and evaluate
optimum anticoagulation management strategies enhanced by expertise from all invested clinician
subspecialties and craft groups. Unfortunately, there are rare opportunities for experts from these professional
groups to collaborate outside of clinical bedside care. Further, clinical trial design is complicated by the need
for multicenter collaboration, lack of standardization, and lack of common definitions of data elements for
study. To meet these challenges, we assembled a multidisciplinary team of experts and key stakeholders to
convene a series of meetings with the following specific aims: AIM 1: Develop evidence-informed consensus
statements for management of anticoagulation for infants and children supported with ECMO, using a
systematic literature review and modified Delphi process. AIM 2: Develop a core set of research priorities and
common data elements for pediatric ECMO anticoagulation studies. AIM 3: Disseminate and implement
anticoagulation management consensus statements, research priorities, and core data elements. Our Key
Deliverables from the PEACE Consensus Conferences will be publication of the systematic reviews including
consensus-based best practice recommendations to optimize care of infants and children managed on ECMO,
identification of key knowledge gaps and research priorities, and definition of consensus-based common data
elements for pediatric ECMO anticoagulation to facilitate multicenter studies and enhance future data synthesis
to improve outcomes for critically ill pediatric ECMO patients. Our collaborative, multidisciplinary PEACE group
and associated research networks stand well poised to design and conduct these future studies.

## Key facts

- **NIH application ID:** 10156954
- **Project number:** 1R13HD104432-01
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Peta-Maree Ann Alexander
- **Activity code:** R13 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $74,880
- **Award type:** 1
- **Project period:** 2021-02-04 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10156954

## Citation

> US National Institutes of Health, RePORTER application 10156954, Pediatric ECMO Anticoagulation Collaborative (PEACE) Consensus (1R13HD104432-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10156954. Licensed CC0.

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