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10.1053/j.jvca.2020.08.067

http://scihub22266oqcxt.onion/10.1053/j.jvca.2020.08.067
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32994131!7473345!32994131
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suck abstract from ncbi


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pmid32994131      J+Cardiothorac+Vasc+Anesth 2021 ; 35 (2): 389-397
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  • Anticoagulation Management in Severe Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation #MMPMID32994131
  • Guo Z; Sun L; Li B; Tian R; Zhang X; Zhang Z; Clifford SP; Liu Y; Huang J; Li X
  • J Cardiothorac Vasc Anesth 2021[Feb]; 35 (2): 389-397 PMID32994131show ga
  • OBJECTIVE: To explore special coagulation characteristics and anticoagulation management in extracorporeal membrane oxygenation (ECMO)-assisted patients with coronavirus disease 2019 (COVID-19). DESIGN: Single-center, retrospective observation of a series of patients. PARTICIPANTS: Laboratory-confirmed severe COVID-19 patients who received venovenous ECMO support from January 20-May 20, 2020. INTERVENTIONS: This study analyzed the anticoagulation management and monitoring strategies, bleeding complications, and thrombotic events during ECMO support. MEASUREMENTS AND MAIN RESULTS: Eight of 667 confirmed COVID-19 patients received venovenous ECMO and had an elevated D-dimer level before and during ECMO support. An ECMO circuit pack (oxygenator and tubing) was replaced a total of 13 times in all 8 patients, and coagulation-related complications included oxygenator thrombosis (7/8), tracheal hemorrhage (5/8), oronasal hemorrhage (3/8), thoracic hemorrhage (3/8), bleeding at puncture sites (4/8), and cannulation site hemorrhage (2/8). CONCLUSIONS: Hypercoagulability and secondary hyperfibrinolysis during ECMO support in COVID-19 patients are common and possibly increase the propensity for thrombotic events and failure of the oxygenator. Currently, there is not enough evidence to support a more aggressive anticoagulation strategy.
  • |*Extracorporeal Membrane Oxygenation/adverse effects[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Anticoagulants/administration & dosage/*therapeutic use[MESH]
  • |COVID-19/complications/diagnostic imaging/*therapy[MESH]
  • |Critical Care[MESH]
  • |Female[MESH]
  • |Fibrin Fibrinogen Degradation Products/analysis[MESH]
  • |Hemorrhage/chemically induced/epidemiology[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Monitoring, Physiologic[MESH]
  • |Respiratory Insufficiency/diagnostic imaging/etiology/therapy[MESH]
  • |Retrospective Studies[MESH]
  • |Thrombosis/epidemiology[MESH]
  • |Tomography, X-Ray Computed[MESH]


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