Acute cardiac care & resuscitationRandomised controlled trial
Standard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial
- Randomised controlled trial
- open-label
- three-arm
- non-inferiority
- 7 Dutch intensive care units (ICUs)
Authors' conclusion
Low-dose UFH and therapeutic LMWH were non-inferior to standard-dose UFH.
Study context
- Population
- Adults on veno-venous or veno-arterial extracorporeal membrane oxygenation (ECMO) in the ICU without vital indication for full-dose anticoagulation320 analysed
- Participants
- 330 adults
- Comparison
- Low-dose unfractionated heparin (UFH) or therapeutic low-molecular-weight heparin (LMWH) vs standard-dose UFH
- Standard-dose UFHn = 110reference
- Low-dose UFHn = 110
- LMWHn = 110
- Primary endpoint
- Composite of:
- Severe bleeding or severe thromboembolic complications during ECMO support
- All-cause mortality
- Follow-up
- 6 months
Primary result
As reported in the abstract
Each group vs standard-dose UFHAbsolute risk difference, percentage points (95% CI)
Low-dose UFH
−9.1(−20.3 to 2.1)
LMWH
−6.1(−17.2 to 5.0)
Non-inferiority margin 7.5 as printed, not drawn
Further findings
All-cause mortality · 6 months
Safety
Severe bleeding · differences not statistically significant
Severe thromboembolic complications · differences not statistically significant
Original publication
Standard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial. Lancet. Published 7 July 2026. doi:10.1016/s0140-6736(26)00851-2
Summarised from the published abstract; every number is checked against it