13.07.2022 | Editorial
Bleeding and clotting while supported with ECMO: time to move forward
verfasst von:
Elias H. Pratt, John W. Stokes, Eddy Fan
Erschienen in:
Intensive Care Medicine
|
Ausgabe 8/2022
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Excerpt
Patients treated with extracorporeal membrane oxygenation (ECMO) often develop coagulopathies, including alterations in both procoagulant and anticoagulant factors, platelet consumption and platelet dysfunction, hyperfibrinolysis, and acquired Von Willebrand syndrome [
1]. Because of this, patients supported with ECMO are at high risk for both bleeding and thrombotic complications. For patients with severe coronavirus disease 2019 (COVID-19), navigating the bleeding and thrombotic complications of ECMO support represents an additional challenge. Critically ill patients with severe COVID-19 may be at increased risk for thrombosis when compared to similar patients without COVID-19 [
2]. As the pandemic has progressed and ECMO has increasingly been used to treat patients with respiratory and circulatory failure from severe COVID-19 [
3], some have suggested that these patients in particular may be at an increased risk of thrombotic complications, and thus require alternative anticoagulation strategies [
4]. …