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Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis
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 treat...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Paris
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949188/ https://www.ncbi.nlm.nih.gov/pubmed/27432243 http://dx.doi.org/10.1186/s13613-016-0172-2 |
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author | Trudzinski, Franziska C. Minko, Peter Rapp, Daniel Fähndrich, Sebastian Haake, Hendrik Haab, Myriam Bohle, Rainer M. Flaig, Monika Kaestner, Franziska Bals, Robert Wilkens, Heinrike Muellenbach, Ralf M. Link, Andreas Groesdonk, Heinrich V. Lensch, Christian Langer, Frank Lepper, Philipp M. |
author_facet | Trudzinski, Franziska C. Minko, Peter Rapp, Daniel Fähndrich, Sebastian Haake, Hendrik Haab, Myriam Bohle, Rainer M. Flaig, Monika Kaestner, Franziska Bals, Robert Wilkens, Heinrike Muellenbach, Ralf M. Link, Andreas Groesdonk, Heinrich V. Lensch, Christian Langer, Frank Lepper, Philipp M. |
author_sort | Trudzinski, Franziska C. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4949188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer Paris |
record_format | MEDLINE/PubMed |
spelling | pubmed-49491882016-07-29 Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis Trudzinski, Franziska C. Minko, Peter Rapp, Daniel Fähndrich, Sebastian Haake, Hendrik Haab, Myriam Bohle, Rainer M. Flaig, Monika Kaestner, Franziska Bals, Robert Wilkens, Heinrike Muellenbach, Ralf M. Link, Andreas Groesdonk, Heinrich V. Lensch, Christian Langer, Frank Lepper, Philipp M. Ann Intensive Care Research 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. Springer Paris 2016-07-19 /pmc/articles/PMC4949188/ /pubmed/27432243 http://dx.doi.org/10.1186/s13613-016-0172-2 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Trudzinski, Franziska C. Minko, Peter Rapp, Daniel Fähndrich, Sebastian Haake, Hendrik Haab, Myriam Bohle, Rainer M. Flaig, Monika Kaestner, Franziska Bals, Robert Wilkens, Heinrike Muellenbach, Ralf M. Link, Andreas Groesdonk, Heinrich V. Lensch, Christian Langer, Frank Lepper, Philipp M. Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title | Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title_full | Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title_fullStr | Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title_full_unstemmed | Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title_short | Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
title_sort | runtime and aptt predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949188/ https://www.ncbi.nlm.nih.gov/pubmed/27432243 http://dx.doi.org/10.1186/s13613-016-0172-2 |
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