Mechanisms of hemorrhagic complications during extracorporeal membrane oxygenation. A pilot study

Bakharev, Sergey A; Александрович, Попугаев Константин; Kiselev, Kirill; Самойлов, А. С.; Удалов, Ю. Д.; Жангазинов, А.Л.; Альтшулер, Н.Э.; Багжанов, Г.И.; Абудеев, С А; Петриков, С. С.

doi:10.17116/anaesthesiology202001125

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…Прогностические шкалы эффективности экстракорпоральной мембранной оксигенации ЭКМО является сложной и дорогостоящей методикой, при этом может сопровождаться рядом серьезных осложнений [11]. Поэтому перед ее проведением необходимо оценить критерии обратимости повреждения легких и прогноз заболевания в целом.…”

Section: Review Articles and Lecturesunclassified

Predictors of extracorporeal membrane oxygenation efficacy in patients with acute respiratory failure

Брыгин¹,

Журавель²,

Троицкий³

et al. 2020

Transplantologiâ (Mosk.)

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The purpose of this article is to describe the problem of predicting the lung function recovery in patients with extracorporeal membrane oxygenation for acute respiratory distress syndrome. Data from CESAR and EOLIA clinical trials on the efficacy of extracorporeal membrane oxygenation in patients with acute respiratory distress syndrome have been reviewed and some controversial results discussed. The prognostic PRESERVE and RESP scores developed as prognostic tools on the basis of the results of these studies, are presented, the limitations of their applicability in various forms of acute respiratory distress syndrome are discussed. We propose to subdivide the predictors of the extracorporeal membrane oxygenation outcome in patients with acute respiratory distress syndrome into 4 following groups: 1. Lung injury severity criteria, including parameters of their lung mechanical and functional properties. 2. Time from acute respiratory failure onset to extracorporeal membrane oxygenation initiation, which reflects the rate of pathological processes in lungs and timing of decision to initiate extracorporeal membrane oxygenation. 3. The etiology of pulmonary disorders, directly affecting the reversibility of pathological processes in the lungs. 4. The severity of the patient's general condition, including the severity of manifestations of multiple organ failure, the degree of decompensation of concomitant chronic diseases, including oncological and associated with immunosuppression. Several diseases are associated with a higher risk of specific complications, particularly hemorrhagic, during extracorporeal membrane oxygenation.

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Section: Review Articles and Lecturesunclassified

Predictors of extracorporeal membrane oxygenation efficacy in patients with acute respiratory failure

Брыгин¹,

Журавель²,

Троицкий³

et al. 2020

Transplantologiâ (Mosk.)

View full text Add to dashboard Cite

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Point of care guided coagulation management in adult patients on ECMO: A systematic review and meta-analysis

Saracoglu,

Fawzy,

Saracoglu

et al. 2024

Journal of Critical Care

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Specific Changes in Hemostasis System Parameters during Extracorporeal Membrane Oxygenation in Patients with a Novel Coronavirus Infection

Zhuravel

Ivanov

Talyzin

et al. 2022

Vestn. anesteziol. reanimatol.

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Extracorporeal membrane oxygenation (ECMO) is a method that makes it possible to compensate for critical changes caused by acute respiratory failure, with the ineffectiveness of treatment with rigid modes of artificial lung ventilation (ventilator) in patients with acute respiratory distress syndrome in intensive care units. The search for the optimal state of the hemostasis system is one of the main tasks in the treatment of critical patients in ECMO conditions.The objective: to study changes in hemostatic parameters in patients with COVID-19 undergoing ECMO and determine the need for their correction.Subjects and Methods. According to the inclusion and exclusion criteria, 100 patients were included in the study: 72 men and 28 women aged 26 to 75 years old, the median age made 55 years [47; 60]. VV-ECMO was performed in all observations. In 100% of cases, the cause of respiratory failure which required VV-ECMO was COVID-19-associated pneumonia.Results. 49 episodes of hemorrhagic complications and 76 episodes of thrombotic complications were recorded from the 1st to the 7th day from the moment of ECMO initiation. We found that the chance of developing thrombosis decreased by an average of 0.3% with an increase in the activity of antithrombin-3 by 1%. A statistically significant association of thrombosis risk was also found for prothrombin and prothrombin time.Conclusion. During the first 7 days of ECMO, patients with COVID-19 demonstrate the increase in APTT, prothrombin time and a decrease in the number of platelets, prothrombin activity, and fibrinogen concentration. The risk of thrombosis in this group of patients significantly decreases with the increasing activity of antithrombin-3 and prothrombin and increases with rising need of the higher dose of unfractionated heparin. The tactics of restrictive anticoagulant therapy when using unfractionated heparin can be taken into account as a way to reduce the risk of thrombosis and requires further research.

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Mechanisms of hemorrhagic complications during extracorporeal membrane oxygenation. A pilot study

Cited by 4 publications

References 22 publications

Predictors of extracorporeal membrane oxygenation efficacy in patients with acute respiratory failure

Predictors of extracorporeal membrane oxygenation efficacy in patients with acute respiratory failure

Point of care guided coagulation management in adult patients on ECMO: A systematic review and meta-analysis

Specific Changes in Hemostasis System Parameters during Extracorporeal Membrane Oxygenation in Patients with a Novel Coronavirus Infection

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