Thrombosis and coagulopathy in COVID-19 patients rceiving ECMO: A narrative review of current literature.
J Cardiothorac Vasc Anesth
; 36(8 Pt B): 3312-3317, 2022 08.
Article
in English
| MEDLINE | ID: covidwho-1768933
ABSTRACT
Extracorporeal membrane oxygenation (ECMO) is an established part of the treatment algorithm for coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. An intense inflammatory response may cause an imbalance in the coagulation cascade making both thrombosis and bleeding common and notable features of the clinical management of these patients. Large observational and retrospective studies provide a better understanding of the pathophysiology and management of bleeding and thrombosis in COVID-19 patients requiring ECMO. Clinically significant bleeding, including intracerebral hemorrhage, is an independent predictor of mortality, and thrombosis (particularly pulmonary embolism) is associated with mortality, especially if occurring with right ventricular dysfunction. The incidence of heparin-induced thrombocytopenia is higher than the general patient cohort with acute respiratory distress syndrome or other indications for ECMO. The use of laboratory parameters to predict bleeding or thrombosis has a limited role. In this review, the authors discuss the complex pathophysiology of bleeding and thrombosis observed in patients with COVID-19 during ECMO support, and their effects on outcomes.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Thrombosis
/
Blood Coagulation Disorders
/
Extracorporeal Membrane Oxygenation
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
J Cardiothorac Vasc Anesth
Journal subject:
Anesthesiology
/
Cardiology
Year:
2022
Document Type:
Article
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