Anticoagulation Management in Severe Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation.
J Cardiothorac Vasc Anesth
; 35(2): 389-397, 2021 Feb.
Article
in English
| MEDLINE | ID: covidwho-807039
ABSTRACT
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 MAINRESULTS:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Extracorporeal Membrane Oxygenation
/
COVID-19
/
Anticoagulants
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Cardiothorac Vasc Anesth
Journal subject:
Anesthesiology
/
Cardiology
Year:
2021
Document Type:
Article
Affiliation country:
J.jvca.2020.08.067
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