09/23/2026
What if less is actually more when it comes to ECMO anticoagulation? 🩸 📰 : https://bit.ly/ratetrial For years, “more” has often felt like the safer answer.
But the new RATE Trial puts that assumption under the microscope.
330 adults on ECMO.
3 anticoagulation strategies.
And some numbers worth paying attention to:
81% — standard-dose IV heparin
72% — lower-dose IV heparin
75% — therapeutic subQ LMWH
Those percentages represent patients who experienced severe bleeding, severe clotting, or death within six months.
And importantly, the lower-intensity strategies didn’t show an obvious increase in serious clotting events.
So…is it time to rethink how much anticoagulation we’re giving ECMO patients?
Not so fast.
RATE doesn’t prove that less anticoagulation is better. It was a non-inferiority trial, and there are important limitations around patient populations, procedures, monitoring, and how broadly we can apply the findings.
But it does give ECMO programs something they haven’t had before: meaningful outcomes data to bring to the anticoagulation conversation.
And that conversation is just getting started.
🔎 We break down the RATE Trial, the numbers, the caveats, and what it could mean for the future of ECMO anticoagulation in the latest Integration Health blog.