Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest.
Bleeding complications
Cardiac arrest
ECLS
Intracranial hemorrhage
Targeted temperature management
Therapeutic hypothermia
VA-ECMO
Journal
Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
25
08
2020
revised:
04
11
2020
accepted:
12
11
2020
pubmed:
24
11
2020
medline:
4
9
2021
entrez:
23
11
2020
Statut:
ppublish
Résumé
Whether therapeutic hypothermia (TH) adds to the risk of bleeding in patients on extracorporeal life support (ECLS) peri-cardiac arrest remains unknown. Single center retrospective study on patients receiving veno-arterial ECLS peri-cardiac arrest ± TH at 32-34 °C (January 2009-December 2015). major bleeding (including intracerebral hemorrhage, ICH) < 72 h of cardiac arrest. Logistic regression and marginal structural models were used to analyze associations with major bleeding. Of 66 patients receiving ECLS, 36 were treated with TH. Major bleeding occurred in 14 patients (39%) treated with ECLS+TH and in 17 patients (57%) with ECLS alone. ICH was reported in 3 (8%) and one patient (3%), respectively. There was no difference in mortality, but lung injury occurred more often in ECLS+TH. A platelet count <60 × 10 Bleeding complications were common in our study. However, TH (32-34 °C) was not associated with an increased risk of major bleeding in patients on ECLS peri-cardiac arrest.
Identifiants
pubmed: 33227591
pii: S0883-9441(20)30763-2
doi: 10.1016/j.jcrc.2020.11.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
12-18Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest AM, JS, FA, LD and GS declare that there were no conflicts of interest to disclose. EF was supported by a New Investigator Award from the Canadian Institutes of Health Research and received personal fees from Abbott, ALung Technologies, and MC3 Cardiopulmonary. AB received honoraria, consultancy fees and research support from Abbott, Abiomed, Berlin Heart, Medtronic, Novartis and Orion Pharma. HR received consultancy fees from Medtronic Advisory Board and travel grants from Grant Abiomed. BS was supported by lecture honoraria by AstraZeneca and funding by the German Research Foundation. DW received personal fees from Bayer, Boehringer-Ingelheim, Berlin Chemie, AstraZeneca, Biotronik and Novartis. SB received lecture honoraria from Getinge and Xenios. SK received lecture honoraria and travel costs from Bard, Baxter, Fresenius, Sorin, Xenios and Zoll. EF, AB, HR, BS, DW, SB and SK declare that they did not receive funding related to this research work.