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Pre-ECMO coagulopathy does not increase the occurrence of hemorrhage during extracorporeal support

Abstract

Introduction and methods

Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children’s hospital.

Results

Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic. In the coagulopathic group, sepsis (27.3%) was the most common diagnosis leading to ECMO. Over half of the patients in both groups (55.9% of the coagulopathic and 52.7% of the noncoagulopathic group) developed hemorrhagic complications during ECMO support. The most frequent bleeding sites for both groups were the cannulation site (24%), the chest tube site (17%), and intracranial (10%). Pre-ECMO coagulopathy was not associated with higher incidence of hemorrhage during extracorporeal support (p = 0.76).

Conclusions

Pre-ECMO coagulopathy was frequent in our cohort but did not increase the occurrence of hemorrhage during extracorporeal support. Although the identification of factors associated with hemorrhage is key to safely managing ECMO anticoagulation, the implication of precannulation coagulopathy seems to be minimal.

Int J Artif Organs 2017; 40(5): 250 - 255

Article Type: SHORT COMMUNICATION

DOI:10.5301/ijao.5000577

Authors

Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake

Article History

Disclosures

Financial support: No funding has been received for this study.
Conflict of interest: The authors declare that there is no conflict of interest of any kind to disclose.

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Authors

Affiliations

  •  Department of Pediatrics, Critical Care Division, University of Texas Southwestern Medical Center, Dallas, TX - USA
  •  Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX - USA
  •  Department of Pediatrics, Trauma Services, Children’s Health Medical Center, Dallas, TX - USA
  •  Department of Pediatrics, Critical Care Division, University of Texas Health Science Center at Houston, Houston, TX - USA
  •  Department of Pediatrics, Hematology-Oncology Division, University of Texas Southwestern Medical Center, Dallas, TX - USA

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