Acquired von Willebrand syndrome in patients with extracorporeal life support (ECLS)

Heilmann, Claudia; Geisen, Ulrich; Beyersdorf, Friedhelm; Nakamura, Lea; Benk, Christoph; Trummer, Christian; Berchtold‐Herz, Michael; Schlensak, Christian; Zieger, Barbara

doi:10.1007/s00134-011-2370-6

Cited by 195 publications

(144 citation statements)

References 35 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…GI bleeding may be more frequent in ECLS patients as a result of multifactorial coagulopathy, generation of systemic inflammation, and nonpulsatile blood flow during VA ECLS, which can lead to reduced gastric perfusion and pH [2][3][4][5]. Future prospective studies would be helpful in confirming our findings.…”

supporting

confidence: 67%

Epidemiology of gastrointestinal bleeding in adult patients on extracorporeal life support

et al. 2015

View full text Add to dashboard Cite

supporting

confidence: 67%

Epidemiology of gastrointestinal bleeding in adult patients on extracorporeal life support

et al. 2015

View full text Add to dashboard Cite

“…Enhanced shear stress at the site of the stenotic valve or in the VAD results in the mechanical destruction of large multimers. As observed in the setting of VAD [16][17][18][19] and cases of aortic stenosis, flow acceleration may be a cause of shear stress in patients treated with ECMO devices, subsequently leading to AVWS.…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Acquired von Willebrand Syndrome (AVWS) is Elementary for Clinical Practice in Patients Treated with ECMO Therapy

Kalbhenn

Schmidt

Nakamura

et al. 2015

J Atheroscler Thromb

Self Cite

102

View full text Add to dashboard Cite

Aims: Acquired Von Willebrand syndrome (AVWS) is an acquired bleeding disorder that has been reported to aggravate bleeding complications in patients with ventricular assist devices or aortic stenosis. AVWS is characterized by the loss of the high-molecular-weight (HMW) multimers of Von Willebrand factor (VWF) with consequent impaired VWF binding to platelets and collagen. The aim of this study was to investigate the development of AVWS in patients treated with veno-venous ECMO (extracorporeal membrane oxygenation) support. Methods: We examined the presence of AVWS in adult patients receiving ECMO support (n 18) and control subjects treated without ECMO support (n 18). The diagnosis of AVWS was made based on the ratio of collagen-binding capacity to VWF-antigen (VWF:CB/VWF:Ag) and a VWF multimeric analysis. In addition, bleeding episodes were monitored. Results: All patients supported with ECMO developed AVWS. AVWS was identified in the early period after ECMO implantation, i.e. within 24 hours after ECMO implantation. In 17 patients, the VWF:CB/VWF:Ag ratio was significantly reduced and HMW multimers were severely missing, and 17 of the 18 patients developed bleeding complications and required transfusions of blood, FFP and/ or platelet concentrates. In addition, nine patients without an ECMO device were investigated (prior to ECMO implantation: n 2, after ECMO explantation: n 7). Conclusions: In this study, all patients treated with ECMO support developed AVWS, and AVWS was detectable within 24 hours after ECMO implantation. However, the AVWS was reversible after ECMO explantation. Making an early diagnosis of AVWS and providing appropriate treatment may reduce the incidence of life-threatening bleeding. See

show abstract

“…There is also the concern for cavitation and hemolysis due to excessive negative pressure (2). In addition, rotary blood pumps are associated with acquired von Willebrand factor deficiency and may contribute to bleeding complications (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

In Vivo Testing of a Novel Blood Pump for Short-Term Extracorporeal Life Support

Teman

Demos

Bryner

et al. 2013

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

Acquired von Willebrand syndrome in patients with extracorporeal life support (ECLS)

Abstract: Our data indicate that AVWS is a typical disorder in patients with ECLS. We hypothesize that AVWS could contribute to aggravation of bleeding tendencies in ECLS patients.

Cited by 195 publications

References 35 publications

Epidemiology of gastrointestinal bleeding in adult patients on extracorporeal life support

Epidemiology of gastrointestinal bleeding in adult patients on extracorporeal life support

Early Diagnosis of Acquired von Willebrand Syndrome (AVWS) is Elementary for Clinical Practice in Patients Treated with ECMO Therapy

In Vivo Testing of a Novel Blood Pump for Short-Term Extracorporeal Life Support

Contact Info

Product

Resources

About