Hemostasis Management during Adult Extracorporeal Membrane Oxygenation: A Shot in the Dark?
DOI:
https://doi.org/10.17140/RPAOJ-1-e001Keywords:
Bleeding, Coagulation, Extracorporeal membrane oxygenation (ECMO)Abstract
Extracorporeal membrane oxygenation (ECMO) has been used increasingly in adult patients with cardiopulmonary failure. According to the Extracorporeal Life Support Organization’s (ELSO’s) 2012 report over 51,000 patients have received ECMO. Most cases are for neonates; however, an increasing proportion is for adults.2 ECMO is a unique life saving therapy, but many patients experience complications including: hemolysis, systemic thromboembolism, neurologic complications, and bleeding.
References
Maxwell BG, Powers AJ, Sheikh AY, et al. Resource use trends in extracorporeal membrane oxygenation: an analysis of the na-tionwide inpatient sample 1998-2009. J Thorac Cardiovasc Surg. 2014; 148: 416-421. doi: 10.1016/j.jtcvs.2013.09.033
Paden ML, Conrad SA, Rycus PT, et al. Extracorporeal life support organization registry report 2012. ASAIO J. 2013; 59(3): 202- 210. doi: 10.1097/MAT.0b013e3182904a52
Makdisi G, Wang I. Extracorporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015; 7(7): E166-E176. doi: 10.3978/j.issn.2072-1439.2015.07.17
Mazzeffi M, Greenwood J, Tanaka K, et al. Bleeding, transfusion, and mortality on extracorporeal life support: ECLS working group on thrombosis and hemostasis. Ann Thorac Surg. 2015; 4975(15): 1250-1253.
Yeo HJ, Kim DH, Jeon D, et al. Low-dose heparin during extracorporeal membrane oxygenation treatment in adults. Intensive Care Med. 2015; 41: 2020-2021. doi: 10.1007/s00134-015-4015-7
Heilman C, Geisen U, Beyersdorf F, et al. Acquired von Willebrand syndrome in patients with extracorporeal life support (ECLS). Intensive Care Med. 2012; 38(1): 62-68. doi: 10.1007/s00134-011-2370-6
Tauber H, Ott H, Streif W, et al. Extracorporeal membrane oxygenation induces short-term loss of high-molecular weight von Willebrand multimers. Anesth Analg. 2015; 120(4): 730-736. doi: 10.1213/ANE.0000000000000554
Mutlak H, Reyher C, Meybohm P, et al. Multiple electrode aggregometry for the assessment of acquired platelet dysfunction dur-ing extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg. 2015; 63(1): 21-27. doi: 10.1055/s-0034-1383817
McVeen RV, Lorch V, Carroll RC, et al. Changes in fibrinolytic factors in newborns during extracorporeal membrane oxygenation. Am J Hematol. 1991; 38(3): 254-255.
Panigada M, Mietto C, Pagan F, et al. Monitoring anticoagulation during extracorporeal membrane oxygenation in patients with acute respiratory failure. Crit Care. 2013; 17(Suppl 2): P126. doi: 10.1186/cc12064
Nair P, Hoechter DJ, Buscher H, et al. Prospective observational study of hemostatic alterations during adult extracorporeal membrane oxygenation (ECMO) using point-of-care thromboelastometry and platelet aggregation. J Cardiothorac Vas Anesth. 2015; 29(2): 288-296. doi: 10.1053/j.jvca.2014.06.006
Raza I, Davenport R, Rourke C, et al. The incidence and magnitude of fibrinolytic activation in trauma patients. J Thromb Hae-most. 2013; 11(2): 307-314. doi: 10.1111/jth.12078
Repesse X, Au SM, Brechot N, et al. Recombinant factor VIIa for uncontrollable bleeding in patients with extracorporeal mem-brane oxygenation: report on 15 cases and literature review. Crit Care. 2013; 17(2): R55. doi: 10.1186/cc12581
Bui JD, Despotis GD, Trulock EP, et al. Fatal thrombosis after administration of activated prothrombin complex concentrates in a patient supported by extracorporeal membrane oxygenation who had received activated recombinant factor VII. J Thorac Cardio-vasc Surg. 2002; 124(4): 852-854. doi: 10.1067/mtc.2002.126038
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Research and Practice in Anesthesiology (RPA) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
