Anticoagulation after VA-ECMO decannulation, providing new insights
نویسندگان
چکیده
Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential tool for the management refractory cardiogenic shock. Little known about incidence thromboembolic events after V-A ECMO decannulation, although some studies report a high cannula-related venous thrombosis venovenous (VV-ECMO). Due to this fact, in our institution anticoagulation therapy systematically prescribed at least 3 months VA-ECMO per protocol. AIM The main objective study was explore feasibility 3-month decannulation. METHODS We performed prospective that included 27 consecutive patients who were successfully treated with medical ICU between 2016 and 2019 protocol Exclusion criteria dying on or while ICU. Data analysis demographics, mean days ECMO, survival, bleeding (excluding immediate post-decannulation bleeding, since 24h after). RESULTS Our cohort consisted mainly men (N = 21, 78%), age 60 ± 11 years time 8 days, primarily suffered from post-cardiotomy shock 9, 34%) acute myocardial infarction 6, 23%). 5 (18%) received heart transplant. Regarding anticoagulation, 15 (60%) had other indications apart protocol, like incidental thrombus diagnosis 7, 26%) valve surgery 5, 18%). Anticoagulation not feasible 1 patient (4%) severe thrombopenia. No life-threatening follow-up, (30%) events, gastrointestinal 4, 15%), requiring withdrawal patient. 7%; two low-risk pulmonary embolisms. During follow-up survival rate 95%. CONCLUSIONS This only date addressing strategy VAECMO, showing it safe may be helpful reducing ameliorate complications exempt complications. Figure. Kaplan-Meier
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ژورنال
عنوان ژورنال: European heart journal. Acute cardiovascular care
سال: 2021
ISSN: ['2048-8726', '2048-8734']
DOI: https://doi.org/10.1093/ehjacc/zuab020.168