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Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements

Background: Bleeding events are frequent complications during extracorporeal membrane oxygenation therapy (ECMO). Objective: To determine the rate of acquired factor XIII deficiency and its association with major bleeding events and transfusion requirements in adults undergoing ECMO therapy. Materia...

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Autores principales: Noitz, Matthias, Brooks, Roxane, Szasz, Johannes, Jenner, Dennis, Böck, Carl, Krenner, Niklas, Dünser, Martin W., Meier, Jens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299514/
https://www.ncbi.nlm.nih.gov/pubmed/37373805
http://dx.doi.org/10.3390/jcm12124115
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author Noitz, Matthias
Brooks, Roxane
Szasz, Johannes
Jenner, Dennis
Böck, Carl
Krenner, Niklas
Dünser, Martin W.
Meier, Jens
author_facet Noitz, Matthias
Brooks, Roxane
Szasz, Johannes
Jenner, Dennis
Böck, Carl
Krenner, Niklas
Dünser, Martin W.
Meier, Jens
author_sort Noitz, Matthias
collection PubMed
description Background: Bleeding events are frequent complications during extracorporeal membrane oxygenation therapy (ECMO). Objective: To determine the rate of acquired factor XIII deficiency and its association with major bleeding events and transfusion requirements in adults undergoing ECMO therapy. Materials and Methods: A retrospective single centre cohort study. Adult patients receiving veno-venous or veno-arterial ECMO therapy during a 2-year period were analysed and screened for factor XIII activity measurements. Factor XIII deficiency was defined based on the lowest factor XIII activity measured during ECMO therapy. Results: Among 84 subjects included into the analysis, factor XIII deficiency occurred in 69% during ECMO therapy. There were more major bleeding events (OR, 3.37; 95% CI, 1.16–10.56; p = 0.02) and higher transfusion requirements (red blood cells, 20 vs. 12, p < 0.001; platelets, 4 vs. 2, p = 0.006) in patients with factor XIII deficiency compared to patients with normal factor XIII activity. In a multivariate regression model, factor XIII deficiency was independently associated with bleeding severity (p = 0.03). Conclusions: In this retrospective single centre study, acquired factor XIII deficiency was observed in 69% of adult ECMO patients with a high bleeding risk. Factor XIII deficiency was associated with higher rates of major bleeding events and transfusion requirements.
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spelling pubmed-102995142023-06-28 Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements Noitz, Matthias Brooks, Roxane Szasz, Johannes Jenner, Dennis Böck, Carl Krenner, Niklas Dünser, Martin W. Meier, Jens J Clin Med Article Background: Bleeding events are frequent complications during extracorporeal membrane oxygenation therapy (ECMO). Objective: To determine the rate of acquired factor XIII deficiency and its association with major bleeding events and transfusion requirements in adults undergoing ECMO therapy. Materials and Methods: A retrospective single centre cohort study. Adult patients receiving veno-venous or veno-arterial ECMO therapy during a 2-year period were analysed and screened for factor XIII activity measurements. Factor XIII deficiency was defined based on the lowest factor XIII activity measured during ECMO therapy. Results: Among 84 subjects included into the analysis, factor XIII deficiency occurred in 69% during ECMO therapy. There were more major bleeding events (OR, 3.37; 95% CI, 1.16–10.56; p = 0.02) and higher transfusion requirements (red blood cells, 20 vs. 12, p < 0.001; platelets, 4 vs. 2, p = 0.006) in patients with factor XIII deficiency compared to patients with normal factor XIII activity. In a multivariate regression model, factor XIII deficiency was independently associated with bleeding severity (p = 0.03). Conclusions: In this retrospective single centre study, acquired factor XIII deficiency was observed in 69% of adult ECMO patients with a high bleeding risk. Factor XIII deficiency was associated with higher rates of major bleeding events and transfusion requirements. MDPI 2023-06-18 /pmc/articles/PMC10299514/ /pubmed/37373805 http://dx.doi.org/10.3390/jcm12124115 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Noitz, Matthias
Brooks, Roxane
Szasz, Johannes
Jenner, Dennis
Böck, Carl
Krenner, Niklas
Dünser, Martin W.
Meier, Jens
Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title_full Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title_fullStr Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title_full_unstemmed Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title_short Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements
title_sort acquired factor xiii deficiency is common during ecmo therapy and associated with major bleeding events and transfusion requirements
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299514/
https://www.ncbi.nlm.nih.gov/pubmed/37373805
http://dx.doi.org/10.3390/jcm12124115
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