An ECMO patient undergoes a head CT that shows a new large intracerebral hemorrhage. The most appropriate anticoagulation adjustment is:
-
A
Discontinue heparin entirely and accept increased thrombosis risk
-
B
Reduce heparin to maintain aPTT 40–50 seconds while monitoring circuit closely
-
C
Increase heparin to prevent embolic stroke extension
-
D
Switch to bivalirudin at full anticoagulation doses