Anti-Xa-guided Anticoagulation With Unfractionated Heparin and Thrombosis During Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-analysis
Pooled result · Mean anti-Xa valuesResult — go to the resultSMD −0.36 95% CI −0.62 to −0.11Authors' conclusion
This work revealed significantly lower levels of anti-Xa in patients experiencing thromboembolic events and a positive correlation between anti-Xa and unfractionated heparin infusion.
Study context
- Population
- Patients receiving extracorporeal membrane oxygenation (ECMO) support with unfractionated heparin anticoagulation16 articles
- Participants
- 1,968 patients
- Comparison
- Anti-Xa levels in patients with vs without thrombosis during ECMO
- Outcome
- Association between anti-Xa levels and thrombosis occurrence during ECMO support
Methodological detailsretrospective and prospective studies, Scopus and PubMed searched up to July 29, 2023
- Retrospective and prospective studies
- Scopus and PubMed searched up to July 29, 2023
Pooled result
Mean anti-Xa values
SMD
−0.36
95% CI −0.62 to −0.11
P < 0.01
Thrombosis vs No thrombosis
SMD −0.36 (95% CI −0.62 to −0.11); P < 0.01
As reported in the abstract
Further pooled results
Correlation between unfractionated heparin infusion and anti-Xa levels
- Pooled estimate of correlation coefficients
- 0.31 (95% CI 0.19 to 0.43, p < 0.001)
Not surviving to discharge
- Patients not surviving to discharge
- 52%
Safety
Adverse events
- Major bleeding
- 42%
- Any kind of hemorrhage
- 36%
- Thromboembolic events
- 30%
- Circuit or oxygenator membrane thrombosis
- 19%
Original publication
Anti-Xa-guided Anticoagulation With Unfractionated Heparin and Thrombosis During Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth. Published 2 April 2024. doi:10.
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