Antithrombin Levels and Heparin Responsiveness during Venoarterial Extracorporeal Membrane Oxygenation: A Prospective Single-center Cohort Study
Authors' conclusion
Venoarterial extracorporeal membrane oxygenation support was associated with a moderate acquired antithrombin deficiency, mainly during the first 72 h, that did not correlate with heparin responsiveness.
Study context
- Population
- Adults receiving venoarterial ECMO with continuous IV unfractionated heparin (target anti-Xa 0.3 to 0.5 IU/ml)42% postcardiotomy
- Participants
- 50 adults
- Outcome
- Antithrombin plasma level (deficiency: time-weighted average ≤70%)
- Follow-up
- 11 time points from hour 0 up to day 7
Methodological detailssingle-centre, Included April 2020 to May 2021; 447 samples
- Single-centre
- Included April 2020 to May 2021; 447 samples
Main finding
As reported in the abstract
Antithrombin plasma level
- Median antithrombin level at baseline (IQR 37 to 60%)
- 48%
- Time-weighted average antithrombin (IQR 57 to 73%)
- 63%
- Time-weighted average antithrombin ≤70% (antithrombin deficiency), n (%)
- 32 (64%)
- At least one antithrombin value <70%, n (%)
- 45 (90%)
- At least one antithrombin value <50%, n (%)
- 35 (70%)
Observational data: associations, not effects.
Further findings
Association of antithrombin levels with heparin responsiveness (anti-Xa assay or heparin dosage)
- Not significantly associated
ECMO duration
- Median ECMO duration, days (IQR 4 to 12)
- 7
Original publication
Antithrombin Levels and Heparin Responsiveness during Venoarterial Extracorporeal Membrane Oxygenation: A Prospective Single-center Cohort Study. Anesthesiology. Published 25 January 2024. doi:10.
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