Association of increased bmi with periprocedural bleeding risk in adult patients with covid-19 on extracorporeal membrane oxygenation who undergo tracheostomy
ASAIO Journal
; 67(SUPPL 3):17, 2021.
Article
in English
| EMBASE | ID: covidwho-1481524
ABSTRACT
Introduction:
Coagulopathy associated with COVID-19 presents a unique challenge when balancing the risk of thromboembolism versus bleeding complications in critically ill patients. This is particularly important in patients receiving extracorporeal membrane oxygenation (ECMO), as anticoagulation is used to offset increased thromboembolic risk, which may put patients at increased risk of periprocedural bleeding. The aim of this study is to evaluate risk of periprocedural bleeding in patients with COVID-19 on ECMO who undergo operative or percutaneous tracheostomy placement.Methods:
This is an IRB approved retrospective chart review of the incidence of periprocedural bleeding in morbidly obese patients on ECMO. Participants included adults ≥18 years of age with laboratory-confirmed COVID-19 who were underwent either remote ECMO cannulation and transfer or where cannulated at an ECMO center. All participants were admitted to an ECMO ICU for daily management and subsequently underwent tracheostomy while on ECMO.Results:
A total of 36 participants were included, of whom 61% were male. Participants had a median age of 47.5 (IQR 37.5-58) years and a median BMI of 38.5 (IQR 29-49) kg/m2, and 15/36 (42%) of patients had a BMI <35 kg/m2. Tracheostomy-associated bleeding occurred in 9/36 (25.0%) of patients. Subgroup analysis showed that in patients with a BMI <35 kg/m2, only 2/15 (13.3%) had periprocedural bleeding. In patients with BMI ≥35 kg/m2, 7/21 (33.3%) had periprocedural bleeding. All patients who had periprocedural bleeding required transfusion with blood products.Conclusion:
Increased BMI is associated with an increased risk of bleeding complications following tracheostomy in patients on ECMO.
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Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
ASAIO Journal
Year:
2021
Document Type:
Article
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