Anticoagulation and Bleeding during Veno-Venous Extracorporeal Membrane Oxygenation: Insights from the PROTECMO Study
Authors' conclusion
Anticoagulation during VV ECMO was a dynamic process, with frequent stopping in cases of bleeding and restart according to the clinical picture.
Study context
- Population
- Adults receiving VV ECMO, 41 centres, December 2018 to February 20218,471 ECMO days analysed
- Participants
- 652 adults
- Outcome
- Anticoagulation and bleeding
Methodological detailsinternational, multicentre
- International
- Multicentre
Main finding
As reported in the abstract
- Unfractionated heparin as initial anticoagulant
- 77%
- Unfractionated heparin, most frequently used anticoagulant during ECMO (days)
- 6,221 d; 73%
- Activated partial thromboplastin time (aPTT) as monitoring test (% of days)
- 86%
- aPTT, median (IQR 39 to 61 s)
- 52 seconds
- aPTT change after first bleeding event (95% CI −7.4 to −3.2; P < 0.01)
- dropped by 5.3 seconds
- Days with bleeding
- 1,202 days (16.5%)
- Patients with ≥1 bleeding event
- 342 patients (52.5%)
- Bleeding frequency
- one episode every 215 h on ECMO
- Fatal bleeding events
- 10 (1.6%)
- Higher aPTT as risk factor for first bleeding (per 20-s increase), HR
- 1.07
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Anticoagulation and Bleeding during Veno-Venous Extracorporeal Membrane Oxygenation: Insights from the PROTECMO Study. Am J Respir Crit Care Med. Published 15 February 2024. doi:10.
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