Extracorporeal membrane oxygenation(ECMO) has emerged as a viable treatment in severe cases of acute respiratory distress syndrome,acute respiratory failure,and adult respiratory distress syndrome.However,thromboembolic events stemming from the use of ECMO devices results in significant morbidity and mortality rates;the inner surface of the ECMO tubing comes into contact with the blood and can readily initiate coagulation.In addition,the tubing needs to be continually replaced due to thromboses on the inner tube wall,which not only increases the risk of infection but also the economic burden.Despite considerable effort,a surface modification strategy that effectively addresses these challenges has not yet been realized.In this study,we developed an integrated hollow core-shell-shell hydrogel tube of gelatin/alginate/acrylamide-bacterial nanocellulose(GAA) that meets the anticoagulant requirements for the inner tubing layer as well as the highly elastic soft material needed for the outer layer.Using static blood from healthy volunteers,we confirmed that the platelets or coagulation is not stimulated by the GAA tubing.Importantly,experiments with dynamic blood also demonstrated that the inner layer of the tubing does not elicit blood clotting.The one-pot-synthesized process may provide guidance for the design of anticoagulation tubes used clinically.