Thrombosis and coagulopathy in COVID-19 patients rceiving ECMO: A narrative review of current literature.
ARDS
Bleeding
COVID-19
ECMO
Thrombosis
Journal
Journal of cardiothoracic and vascular anesthesia
ISSN: 1532-8422
Titre abrégé: J Cardiothorac Vasc Anesth
Pays: United States
ID NLM: 9110208
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
27
01
2022
revised:
25
03
2022
accepted:
28
03
2022
pubmed:
17
5
2022
medline:
16
6
2022
entrez:
16
5
2022
Statut:
ppublish
Résumé
Extracorporeal membrane oxygenation (ECMO) is an established part of the treatment algorithm for coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. An intense inflammatory response may cause an imbalance in the coagulation cascade making both thrombosis and bleeding common and notable features of the clinical management of these patients. Large observational and retrospective studies provide a better understanding of the pathophysiology and management of bleeding and thrombosis in COVID-19 patients requiring ECMO. Clinically significant bleeding, including intracerebral hemorrhage, is an independent predictor of mortality, and thrombosis (particularly pulmonary embolism) is associated with mortality, especially if occurring with right ventricular dysfunction. The incidence of heparin-induced thrombocytopenia is higher than the general patient cohort with acute respiratory distress syndrome or other indications for ECMO. The use of laboratory parameters to predict bleeding or thrombosis has a limited role. In this review, the authors discuss the complex pathophysiology of bleeding and thrombosis observed in patients with COVID-19 during ECMO support, and their effects on outcomes.
Identifiants
pubmed: 35577652
pii: S1053-0770(22)00211-7
doi: 10.1053/j.jvca.2022.03.032
pmc: PMC8969294
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3312-3317Informations de copyright
Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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