PMID- 38095743
OWN - NLM
STAT- MEDLINE
DCOM- 20240326
LR  - 20240420
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 57
IP  - 3
DP  - 2024 Mar
TI  - Predictors of thrombosis during VV ECMO: an analysis of 9809 patients from the 
      ELSO registry.
PG  - 345-351
LID - 10.1007/s11239-023-02909-4 [doi]
AB  - Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving therapy 
      for critically ill patients, but it carries an increased risk of thrombosis due 
      to blood interacting with non-physiological surfaces. While the relationship 
      between clinical variables and thrombosis remains unclear, our study aimed to 
      identify which factors are most predictive of thrombosis. The Extracorporeal Life 
      Support Organization Registry was queried to obtain a cohort of VV-ECMO patients 
      aged 18 years and older from 2015 to 2019. Patients who were over 80-years-old, 
      at the extremes of weight, who received less than 24 h of ECMO, multiple rounds 
      of ECMO, or had missing data were excluded. Multivariate logistic regression 
      modeling was used to assess predictors of thrombosis and mortality. A total of 
      9809 patients were included in the analysis, with a mean age of 47.1 +/- 15.1 years 
      and an average ECMO run time of 305 +/- 353 h. Thrombosis occurred in 19.9% of the 
      cohort, with circuit thrombosis (8.6%) and membrane lung failure (6.1%) being the 
      most common. Multivariate analysis showed that ECMO runs over 14 days (OR: 2.62, 
      P < 0.001) and pregnancy-related complications (OR: 1.79, P = 0.004) were 
      associated with an increased risk of thrombosis. Risk factors for circuit 
      thrombosis included incremental unit increases in the pump flow rate at 24 h (OR: 
      1.07 [1.00-1.14], P = 0.044) and specific cannulation sites. Increased body 
      weight (OR: 1.02 [1.00-1.04], P = 0.026) and increased duration on ECMO (OR: 3.82 
      [3.12-4.71], P < 0.001) were predictive of membrane lung failure. Additionally, 
      patients with thrombosis were at increased likelihood of in-hospital mortality 
      (OR: 1.52, P < 0.001). This study identified multiple thrombotic risk factors in 
      VV-ECMO, suggesting that future studies investigating the impact of pregnancy 
      associated complications and ECMO flow rate on hemostasis would be illuminating.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Kohs, Tia C L
AU  - Kohs TCL
AUID- ORCID: 0000-0002-7900-0016
AD  - Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. 
      Bond Avenue, Portland, OR, 97239, USA. kohst@ohsu.edu.
FAU - Weeder, Benjamin R
AU  - Weeder BR
AD  - Program in Molecular and Cellular Biology, Oregon Health & Science University, 
      Portland, OR, USA.
FAU - Chobrutskiy, Boris I
AU  - Chobrutskiy BI
AD  - Department of Internal Medicine, Oregon Health & Science University, Portland, 
      OR, USA.
FAU - Kartika, Thomas
AU  - Kartika T
AD  - Department of Internal Medicine, Oregon Health & Science University, Portland, 
      OR, USA.
FAU - Moore, Kerry K
AU  - Moore KK
AD  - Department of Pharmacy, Oregon Health & Science University, Portland, OR, USA.
FAU - McCarty, Owen J T
AU  - McCarty OJT
AD  - Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. 
      Bond Avenue, Portland, OR, 97239, USA.
FAU - Zonies, David
AU  - Zonies D
AD  - Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, 
      Oregon Health & Science University, Portland, OR, USA.
FAU - Zakhary, Bishoy
AU  - Zakhary B
AD  - Department of Pulmonary and Critical Care Medicine, Oregon Health & Science 
      University, Portland, OR, USA.
FAU - Shatzel, Joseph J
AU  - Shatzel JJ
AD  - Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. 
      Bond Avenue, Portland, OR, 97239, USA.
AD  - Division of Hematology and Oncology, Oregon Health & Science University, 
      Portland, OR, USA.
LA  - eng
GR  - R01 HL151367/HL/NHLBI NIH HHS/United States
GR  - R01HL101972/HL/NHLBI NIH HHS/United States
GR  - R01HL151367/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20231214
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
SB  - IM
MH  - Humans
MH  - Adult
MH  - Middle Aged
MH  - Aged, 80 and over
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Retrospective Studies
MH  - *Thrombosis/epidemiology/etiology
MH  - Catheterization/adverse effects
MH  - Registries
MH  - *Respiratory Insufficiency/etiology
OTO - NOTNLM
OT  - Cardiology
OT  - Extracorporeal circulation
OT  - Thrombosis
EDAT- 2023/12/14 12:41
MHDA- 2024/03/26 06:45
CRDT- 2023/12/14 11:10
PHST- 2023/10/22 00:00 [accepted]
PHST- 2024/03/26 06:45 [medline]
PHST- 2023/12/14 12:41 [pubmed]
PHST- 2023/12/14 11:10 [entrez]
AID - 10.1007/s11239-023-02909-4 [pii]
AID - 10.1007/s11239-023-02909-4 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2024 Mar;57(3):345-351. doi: 10.1007/s11239-023-02909-4. 
      Epub 2023 Dec 14.