Evaluation of the Nautilus Smart Extracorporeal Membrane Oxygenation in Patients With Hemostatic Alteration: A Case Series

: The intricate management of hemostatic disorders in extracorporeal membrane oxygenation (ECMO) assisted patients poses challenges, particularly when procoagulant administration is necessary. We hereby report the performance of the Nautilus* Smart ECMO Module in three patients with hemostatic disorders. We collected data from ECMO procedures with Nautilus* Smart ECMO Module and analyzed the performance: the operating pressures and resistance of the device in addition to the coagulation status of the patients. During the three procedures, partial pressure oxygen post-oxygenator (paO2) stayed above 100 mm Hg and partial pressure carbon dioxide post-oxygenator (paCO2) did not exceed 45 mm Hg. Membrane FiO2 (fractional inspired O2) did not exceed 75% and air flow remained within a 1:1 ratio with blood flow in veno-arterial ECMO (V-A) and within 1:2 in veno-venous ECMO (V-V). There was no evidence of excessive operating pressure for the device, with a pressure drop consistently below 28 mm Hg and a maximum peak resistance of 7 Δmm Hg/L/min. The Nautilus* Smart ECMO Module showed good performance in patients with hemostatic disorders despite the implications associated with procoagulant administration.