Ried, Michael and Sommerauer, Laura and Lubnow, Matthias and Mueller, Thomas and Philipp, Alois and Lunz, Dirk and Hofmann, Hans-Stefan (2018) Thoracic Bleeding Complications in Patients With Venovenous Extracorporeal Membrane Oxygenation. ANNALS OF THORACIC SURGERY, 106 (6). pp. 1668-1674. ISSN 0003-4975, 1552-6259
Full text not available from this repository. (Request a copy)Abstract
Background. Patients with respiratory failure are treated more frequently with venovenous extracorporeal membrane oxygenation (vv-ECMO). These patients are at risk for bleeding due to complex multifactorial coagulation disorders resulting from the extracorporeal circulation. Methods. A retrospective analysis was conducted of prospectively collected data on all patients requiring vv-ECMO between December 2010 and December 2016. End points were the incidence, consequence, and in-hospital mortality of patients with thoracic bleeding complications. Results. The study included 418 patients (aged 50 +/- 16.5 years) requiring vv-ECMO. In 23.2% (n = 97) of patients, relevant hemorrhage was documented. Thoracic bleeding developed in 40 patients (41.2%), followed by diffuse (21.6%), cerebral (14.4%), gastrointestinal (6.2%), cannulation site (6.2%), and other bleeding locations. Thoracic bleeding complications occurred spontaneously (40%), postoperatively (37.5%), after interventions (20%), and after trauma (2.5%). A thoracic operation was performed in 60% (n = 24) of these patients, and a repeated operation due to bleeding was necessary in 45.8%. Mean ECMO duration (18.6 +/- 16.8 days; p = 0.035) and hospital length of stay (58 +/- 50 days; p = 0.002) were significantly longer than that in patients without bleeding. In-hospital mortality was significantly higher in patients with thoracic bleeding complications (52.5%) than in patients without bleeding complications (32.7%; p = 0.013). Conclusions. Thoracic bleeding complications were observed in 9.6% of patients and represented the most frequent bleeding complication during vv-ECMO treatment. Almost 60% of patients required surgical revision, and nearly half of these patients underwent a repeated operation. Because mortality is high in these patients, vv-ECMO should be performed in only centers experienced with thoracic surgery. (C) 2018 by The Society of Thoracic Surgeons
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RESPIRATORY-DISTRESS-SYNDROME; INTENSIVE-CARE UNITS; LIFE-SUPPORT; ADULTS; MORTALITY; TRANSFUSION; HEMOSTASIS; DEFINITION; ECMO; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Thoraxchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Oct 2019 05:59 |
| Last Modified: | 09 Oct 2019 05:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13490 |
Actions (login required)
 |
View Item |
