Your browser doesn't support javascript.
loading
Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest.
Mecklenburg, Anne; Stamm, Johannes; Angriman, Federico; Del Sorbo, Lorenzo; Fan, Eddy; Soeffker, Gerold; Bernhardt, Alexander; Reichenspurner, Herrmann; Schrage, Benedikt; Westermann, Dirk; Braune, Stephan; Kluge, Stefan.
Afiliação
  • Mecklenburg A; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Interdepartmental Division of Critical Care Medicine, Toronto General Hospital, 585 University Avenue, Toronto, ON M5G 2N2, Canada. Electronic address: a.mecklenburg@uke.de.
  • Stamm J; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
  • Angriman F; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
  • Del Sorbo L; Interdepartmental Division of Critical Care Medicine, Toronto General Hospital, 585 University Avenue, Toronto, ON M5G 2N2, Canada.
  • Fan E; Interdepartmental Division of Critical Care Medicine, Toronto General Hospital, 585 University Avenue, Toronto, ON M5G 2N2, Canada.
  • Soeffker G; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
  • Bernhardt A; Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
  • Reichenspurner H; Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
  • Schrage B; Department of General and Interventional Cardiology, University Heart Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
  • Westermann D; Department of General and Interventional Cardiology, University Heart Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
  • Braune S; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
  • Kluge S; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
J Crit Care ; 62: 12-18, 2021 04.
Article em En | MEDLINE | ID: mdl-33227591
PURPOSE: Whether therapeutic hypothermia (TH) adds to the risk of bleeding in patients on extracorporeal life support (ECLS) peri-cardiac arrest remains unknown. MATERIAL AND METHODS: Single center retrospective study on patients receiving veno-arterial ECLS peri-cardiac arrest ± TH at 32-34 °C (January 2009-December 2015). PRIMARY OUTCOME: major bleeding (including intracerebral hemorrhage, ICH) < 72 h of cardiac arrest. Logistic regression and marginal structural models were used to analyze associations with major bleeding. RESULTS: Of 66 patients receiving ECLS, 36 were treated with TH. Major bleeding occurred in 14 patients (39%) treated with ECLS+TH and in 17 patients (57%) with ECLS alone. ICH was reported in 3 (8%) and one patient (3%), respectively. There was no difference in mortality, but lung injury occurred more often in ECLS+TH. A platelet count <60 × 109/L but not TH was associated with major bleeding (including ICH). The estimated causal risk ratio of TH on the occurrence of major bleeding (including ICH) at 72 h post cardiac arrest was 0.95 (95%CI 0.62-1.45). CONCLUSIONS: Bleeding complications were common in our study. However, TH (32-34 °C) was not associated with an increased risk of major bleeding in patients on ECLS peri-cardiac arrest.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigenação por Membrana Extracorpórea / Parada Cardíaca / Hipotermia Induzida Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigenação por Membrana Extracorpórea / Parada Cardíaca / Hipotermia Induzida Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos