Thromboembolic and Bleeding Events in COVID-19 Patients receiving Extracorporeal Membrane Oxygenation.
Thorac Cardiovasc Surg
; 69(6): 526-536, 2021 09.
Article
in En
| MEDLINE
| ID: mdl-33862633
ABSTRACT
BACKGROUND:
Extracorporeal membrane oxygenation (ECMO) is a potential treatment option in critically ill COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) if mechanical ventilation (MV) is insufficient; however, thromboembolic and bleeding events (TEBE) during ECMO treatment still need to be investigated.METHODS:
We conducted a retrospective, single-center study including COVID-19 patients treated with ECMO. Additionally, we performed a univariate analysis of 85 pre-ECMO variables to identify factors influencing incidences of thromboembolic events (TEE) and bleeding events (BE), respectively.RESULTS:
Seventeen patients were included; the median age was 57 years (interquartile range [IQR] 51.5-62), 11 patients were males (65%), median ECMO duration was 16 days (IQR 10.5-22), and the overall survival was 53%. Twelve patients (71%) developed TEBE. We observed 7 patients (41%) who developed TEE and 10 patients (59%) with BE. Upper respiratory tract (URT) bleeding was the most frequent BE with eight cases (47%). Regarding TEE, pulmonary artery embolism (PAE) had the highest incidence with five cases (29%). The comparison of diverse pre-ECMO variables between patients with and without TEBE detected one statistically significant value. The platelet count was significantly lower in the BE group (n = 10) than in the non-BE group (n = 7) with 209 (IQR 145-238) versus 452 G/L (IQR 240-560), with p = 0.007.CONCLUSION:
This study describes the incidences of TEE and BE in critically ill COVID-19 patients treated with ECMO. The most common adverse event during ECMO support was bleeding, which occurred at a comparable rate to non-COVID-19 patients treated with ECMO.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thromboembolism
/
Extracorporeal Membrane Oxygenation
/
COVID-19
/
Hemorrhage
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Thorac Cardiovasc Surg
Year:
2021
Document type:
Article
Affiliation country:
Alemania