Commercial and novel anticoagulant ECMO coatings: a review

Zhao, C.Y.; Sheng, Kangjia; Bao, Tao; Shi, Tao; Liu, Peinan; Yang, Yan; Zheng, Xinglong

doi:10.1039/d3tb00471f

Cited by 3 publications

(1 citation statement)

References 71 publications

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“…Patients receiving ECMO have a higher risk of secondary bleeding due to systemic anticoagulation and lack of coagulation factors. Blood transfusion may increase the incidence of primary graft dysfunction (PGD) in patients undergoing lung transplant patients ( 11 - 13 ). Other complications include cardiac tamponade, infection, thrombosis, and gas embolism, which may delay postoperative recovery and increase mortality ( 14 - 16 ).…”

Section: Introductionmentioning

confidence: 99%

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

Zhang,

Li,

Xie

et al. 2024

J Thorac Dis

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Background Extracorporeal membrane oxygenation (ECMO) has been increasingly used as life support for lung transplantation. However, there are no clinical risk models to predict whether ECMO support is required for lung transplantation. This study developed a simple risk score to predict the need for intraoperative ECMO in patients undergoing lung transplantation, identify high-risk patients who need ECMO support, and guide clinical interventions. Methods Patients, who underwent lung transplantation between January 1, 2016 and July 31, 2021, were systematically reviewed. All enrolled patients were divided in a ratio of 7:3 to establish the development and validation datasets. A risk score model was established using stepwise logistic regression and verified using bootstrapping and the split-sample method. Results A total of 248 patients who underwent lung transplants were enrolled. Multivariate analysis showed that the primary disease diagnosis, pulmonary artery systolic pressure, sex, surgical type, creatine kinase isoenzyme-MB, and pro-B-type natriuretic peptide were risk factors for intraoperative ECMO during lung transplantation. The risk score was established and calibrated according to these six factors, ranging from 0 to 41, with the associated prediction of intraoperative use of ECMO ranging from 1.5% to 99.7% (Hosmer-Lemeshow χ 2 =5.624; P=0.689). Good discrimination was verified by developing and validating the datasets (C-statistics =0.850 and 0.842, respectively). Based on the distribution of the scores, the three levels were classified as low-risk (0–10], moderate-risk (10–20], and high-risk (20–41]. Conclusions This simple risk score model effectively predicts the need for intraoperative ECMO and stratifies high-risk patients who require ECMO support.

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Section: Introductionmentioning

confidence: 99%

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

Zhang,

Li,

Xie

et al. 2024

J Thorac Dis

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Endothelial membrane mimetic coating modified dialyzer for hemocompatible and anticoagulant-free hemodialysis

Sun,

Yang,

et al. 2024

Journal of Membrane Science

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Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study

Hileman,

Martucci,

Rizzitello

et al. 2024

Perfusion

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Introduction Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation (VV ECMO) has a strong pathophysiological rationale. Methods This is a single-center, retrospective cohort study of adult VV ECMO patients with anticoagulation maintained by UFH targeting an activated partial thromboplastin time (aPTT) of 40–50 s and AT activity >80%. We compare anticoagulation management and survival outcomes between AT subpopulations, defined by a threshold AT activity ≥80%. Linear and logistic regression analyses were used to evaluate the variation in AT activity and its association with ICU survival. Results In 244 patients enrolled from 2009 to 2022, anticoagulation was maintained by a median heparin dose of 11.4 IU/kg/h [IQR: 8.2–14.7] with a mean aPTT of 46.1 s (±7.3) and AT activity of 88.9% (±17.0). A lower mean aPTT, higher dose of UFH and shorter fraction of time without UFH were associated with higher AT activity ( p < .01). Higher AT activity showed a consistent association with ICU survival (for 10% increase of AT, odds ratio for ICU mortality: 0.95; 95% CI 0.93–0.97; p value <.01). Conclusions There is a positive association between AT activity and UFH requirements but no significant difference in the rate of bleeding events. A higher mean AT during VV ECMO was associated with ICU survival. Future studies are needed to differentiate between exogenously supplemented versus endogenous AT effect.

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Commercial and novel anticoagulant ECMO coatings: a review

Abstract: Extracorporeal membrane oxygenation (ECMO) is an invasive and last-resort treatment for circulatory and respiratory failure. Prolonged ECMO support can disrupt the coagulation and anticoagulation systems in a patient, leading to...

Cited by 3 publications

References 71 publications

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

Endothelial membrane mimetic coating modified dialyzer for hemocompatible and anticoagulant-free hemodialysis

Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study

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