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Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival
BACKGROUND: Patients with severe coronavirus disease‐19 (COVID‐19)‐associated acute respiratory distress on venovenous extracorporeal lung support (V‐V ECLS) showed a high incidence of vascular as well as ECLS‐related thrombotic complications. The latter may influence the outcome of the patients. ME...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111222/ https://www.ncbi.nlm.nih.gov/pubmed/35192198 http://dx.doi.org/10.1111/aor.14218 |
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author | Lehle, Karla Philipp, Alois Foltan, Maik Schettler, Frank Ritzka, Markus Müller, Thomas Lubnow, Matthias |
author_facet | Lehle, Karla Philipp, Alois Foltan, Maik Schettler, Frank Ritzka, Markus Müller, Thomas Lubnow, Matthias |
author_sort | Lehle, Karla |
collection | PubMed |
description | BACKGROUND: Patients with severe coronavirus disease‐19 (COVID‐19)‐associated acute respiratory distress on venovenous extracorporeal lung support (V‐V ECLS) showed a high incidence of vascular as well as ECLS‐related thrombotic complications. The latter may influence the outcome of the patients. METHODS: This is a retrospective monocentric study on prospectively collected data of technical complications including 69 adult COVID‐19 patients on V‐V ECLS (ECLS Registry, March 2020 until April 2021) without and with system exchanges. Alterations in ECLS‐specific data, hemolysis, coagulation, and hemostasis parameters were analyzed. RESULTS: Every second COVID‐19 patient on V‐V ECLS developed technical complications. Optimized ECLS management at our ECLS center reduced cases of acute clot formation (pump head thrombosis, acute oxygenator thrombosis) (17%), and allowed early identification of progressive clotting processes (worsened gas transfer, coagulation disorder) (14%, 54%) with a significant overhang of hyperfibrinolysis (37%). Although COVID‐19 disease and technical complications caused the prolonged length of stay at the intensive care unit and ECLS support times, the proportion of successful weaning and survival rates were comparable with patients without system exchange. CONCLUSION: The survival of ECLS patients with COVID‐19 was independent of the requirement for system exchange due to technical‐induced coagulation disorders. Close monitoring for circuit clotting is mandatory in COVID‐19 patients and is one prerequisite for successful organ support in these difficult patients. |
format | Online Article Text |
id | pubmed-9111222 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91112222022-05-17 Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival Lehle, Karla Philipp, Alois Foltan, Maik Schettler, Frank Ritzka, Markus Müller, Thomas Lubnow, Matthias Artif Organs Main Text BACKGROUND: Patients with severe coronavirus disease‐19 (COVID‐19)‐associated acute respiratory distress on venovenous extracorporeal lung support (V‐V ECLS) showed a high incidence of vascular as well as ECLS‐related thrombotic complications. The latter may influence the outcome of the patients. METHODS: This is a retrospective monocentric study on prospectively collected data of technical complications including 69 adult COVID‐19 patients on V‐V ECLS (ECLS Registry, March 2020 until April 2021) without and with system exchanges. Alterations in ECLS‐specific data, hemolysis, coagulation, and hemostasis parameters were analyzed. RESULTS: Every second COVID‐19 patient on V‐V ECLS developed technical complications. Optimized ECLS management at our ECLS center reduced cases of acute clot formation (pump head thrombosis, acute oxygenator thrombosis) (17%), and allowed early identification of progressive clotting processes (worsened gas transfer, coagulation disorder) (14%, 54%) with a significant overhang of hyperfibrinolysis (37%). Although COVID‐19 disease and technical complications caused the prolonged length of stay at the intensive care unit and ECLS support times, the proportion of successful weaning and survival rates were comparable with patients without system exchange. CONCLUSION: The survival of ECLS patients with COVID‐19 was independent of the requirement for system exchange due to technical‐induced coagulation disorders. Close monitoring for circuit clotting is mandatory in COVID‐19 patients and is one prerequisite for successful organ support in these difficult patients. John Wiley and Sons Inc. 2022-03-03 2022-08 /pmc/articles/PMC9111222/ /pubmed/35192198 http://dx.doi.org/10.1111/aor.14218 Text en © 2022 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Main Text Lehle, Karla Philipp, Alois Foltan, Maik Schettler, Frank Ritzka, Markus Müller, Thomas Lubnow, Matthias Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title | Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title_full | Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title_fullStr | Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title_full_unstemmed | Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title_short | Coagulation abnormalities in patients with COVID‐19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival |
title_sort | coagulation abnormalities in patients with covid‐19 on venovenous ecls increased risk for technical complications and support times but had no impact on survival |
topic | Main Text |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111222/ https://www.ncbi.nlm.nih.gov/pubmed/35192198 http://dx.doi.org/10.1111/aor.14218 |
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