• Minerva anestesiologica · Jan 2020

    Predictors of bleeding in ECMO patients undergoing surgery.

    • Florian Holzer, Michael Gruber, Alois Philipp, Dirk Lunz, Bernhard Graf, and Andreas Redel.
    • Department of Anesthesiology, University Medical Center, Regensburg, Germany - florian.holzer@ukr.de.
    • Minerva Anestesiol. 2020 Jan 1; 86 (1): 47-55.

    BackgroundBleeding is a major adverse effect of veno-venous extracorporeal membrane oxygenation (vvECMO) therapy in surgical patients. This study retrospectively describes the amount of transfused packed red blood cells (PRBC) and coagulation parameters of patients requiring surgery during vvECMO therapy.MethodsWe included patients who underwent at least one surgical procedure during vvECMO therapy and analyzed hemoglobin levels, coagulation parameters, blood gas parameters and transfused blood products. Patients with perioperative transfusion of less than two PRBC during the perioperative period (group A) were compared to those who were given two or more PRBCs (group B).ResultsSeventy-three patients (group A: 42 patients, group B: 31 patients) were included. Activated PTT (54.7 vs. 56.2 sec), Quick test (61.5% vs. 60.0%), Platelet count (91 vs 72 / nL, P=0.322) and mortality (40.5 vs. 45.2%; P=0.689) were not different between both groups. Fibrinogen was significantly decreased in group B (245 mg/dL) compared to group A (353 mg/dL; P=0.004).ConclusionsIn patients requiring surgery during vvECMO therapy with perioperative transfusion of two or more PRBCs preoperative fibrinogen levels were significantly reduced compared to patients with transfusion of less than two PRBCs. No other analyzed lab value showed any predictive qualities in terms of bleeding.

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