Impact of C-reactive Protein on Anticoagulation Monitoring in Extracorporeal Membrane Oxygenation
Main finding · PTT (seconds), simultaneously measuredResult — go to the resultDifference 11.3 secondsAuthors' conclusion
Elevations in CRP are common during ECMO and can falsely prolong PTT measured by commonly used assays.
Study context
- Population
- Adult venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) patients anticoagulated with heparin, university-affiliated tertiary academic medical center371 ECMO days
- Participants
- 30 participants
- Exposure
- Routine partial thromboplastin time (PTT) assay vs C-Reactive protein (CRP)-insensitive PTT assay
- Outcome
- PTT (seconds), simultaneously measured
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Difference
11.3 seconds
P < 0.001
By group
PTT
58.9
median · IQR 46.9–73.3
PTT-CRP
47.6
median · IQR 40.1–55.5
Observational data: associations, not effects.
Further findings
| Outcome | PTT | P value |
|---|---|---|
| PTT after transition to argatroban (subgroup) | median 62.1 (IQR 53.0-78.5 seconds) seconds | P < 0.001 |
CRP levels (mg/dL)
- Median CRP (IQR 9.2-26.1), significantly elevated
- 17.2
- Patients with CRP ≥5
- 93%
PTT minus PTT-CRP difference by CRP level
- CRP <5.0
- 2.7
- CRP 5-10
- 13.0
- CRP 10-15
- 17.7
- CRP >15
- 15.1
- p < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of C-reactive Protein on Anticoagulation Monitoring in Extracorporeal Membrane Oxygenation. J Cardiothorac Vasc Anesth. Published 5 April 2024. doi:10.
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