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. 2016 Dec;6(1):66.
doi: 10.1186/s13613-016-0172-2. Epub 2016 Jul 19.

Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis

Franziska C Trudzinski  1 , Peter Minko  2 , Daniel Rapp  3 , Sebastian Fähndrich  1 , Hendrik Haake  4 , Myriam Haab  5 , Rainer M Bohle  5 , Monika Flaig  1 , Franziska Kaestner  1 , Robert Bals  1 , Heinrike Wilkens  1 , Ralf M Muellenbach  6 , Andreas Link  7 , Heinrich V Groesdonk  8 , Christian Lensch  1 , Frank Langer  9 , Philipp M Lepper  10
Affiliations

Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis

Franziska C Trudzinski et al. Ann Intensive Care. 2016 Dec.

Abstract

Background: Even though bleeding and thromboembolic events are major complications of extracorporeal membrane oxygenation (ECMO), data on the incidence of venous thrombosis (VT) and thromboembolism (VTE) under ECMO are scarce. This study analyzes the incidence and predictors of VTE in patients treated with ECMO due to respiratory failure.

Methods: Retrospective analysis of patients treated on ECMO in our center from 04/2010 to 11/2015. Patients with thromboembolic events prior to admission were excluded. Diagnosis was made by imaging in survivors and postmortem examination in deceased patients.

Results: Out of 102 screened cases, 42 survivors and 21 autopsy cases [mean age 46.0 ± 14.4 years; 37 (58.7 %) males] fulfilling the above-mentioned criteria were included. Thirty-four patients (54.0 %) underwent ECMO therapy due to ARDS, and 29 patients (46.0 %) with chronic organ failure were bridged to lung transplantation. Despite systemic anticoagulation at a mean PTT of 50.6 ± 12.8 s, [VT/VTE 47.0 ± 12.3 s and no VT/VTE 53.63 ± 12.51 s (p = 0.037)], VT and/or VTE was observed in 29 cases (46.1 %). The rate of V. cava thrombosis was 15/29 (51.7 %). Diagnosis of pulmonary embolism prevailed in deceased patients [5/21 (23.8 %) vs. 2/42 (4.8 %) (p = 0.036)]. In a multivariable analysis, only aPTT and time on ECMO predicted VT/VTE. There was no difference in the incidence of clinically diagnosed VT in ECMO survivors and autopsy findings.

Conclusions: Venous thrombosis and thromboembolism following ECMO therapy are frequent. Quality of anticoagulation and ECMO runtime predicted thromboembolic events.

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Figures

Fig. 1
Fig. 1
Consort diagram of patients included in the analysis. Six patients from the ICUs of the Depts. of Anaesthesiology and Cardiology were added to the cohort that met the inclusion criteria. CTEPH chronic thromboembolic pulmonary hypertension, PA partial autopsy only, AT preexisting atrial thrombus
See this image and copyright information in PMC

References

    1. Virchow R, editor. Gesammelte Abhandlungen zur Wissenschaftlichen Medicin. 2. Frankfurt: G. Grote’sche Buchhandlung; 1862.
    1. Wolberg AS, Aleman MM, Leiderman K, Machlus KR. Procoagulant activity in hemostasis and thrombosis: Virchow’s triad revisited. Anesth Analg. 2012;114(2):275–285. doi: 10.1213/ANE.0b013e31823a088c. - DOI - PMC - PubMed
    1. Murphy DA, Hockings LE, Andrews RK, Aubron C, Gardiner EE, Pellegrino VA, et al. Extracorporeal membrane oxygenation-hemostatic complications. Transfus Med Rev. 2015;29(2):90–101. doi: 10.1016/j.tmrv.2014.12.001. - DOI - PubMed
    1. Weingart C, Lubnow M, Philipp A, Bein T, Camboni D, Muller T. Comparison of coagulation parameters, anticoagulation, and need for transfusion in patients on interventional lung assist or veno-venous extracorporeal membrane oxygenation. Artif Organs. 2015;39:765. doi: 10.1111/aor.12464. - DOI - PubMed
    1. Zangrillo A, Landoni G, Biondi-Zoccai G, Greco M, Greco T, Frati G, et al. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc. 2013;15(3):172–178. - PubMed

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