Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest
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Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest. / Mecklenburg, Anne; Stamm, Johannes; Angriman, Federico; Del Sorbo, Lorenzo; Fan, Eddy; Soeffker, Gerold; Bernhardt, Alexander; Reichenspurner, Herrmann; Schrage, Benedikt; Westermann, Dirk; Braune, Stephan; Kluge, Stefan.
in: J CRIT CARE, Jahrgang 62, 04.2021, S. 12-18.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest
AU - Mecklenburg, Anne
AU - Stamm, Johannes
AU - Angriman, Federico
AU - Del Sorbo, Lorenzo
AU - Fan, Eddy
AU - Soeffker, Gerold
AU - Bernhardt, Alexander
AU - Reichenspurner, Herrmann
AU - Schrage, Benedikt
AU - Westermann, Dirk
AU - Braune, Stephan
AU - Kluge, Stefan
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - PURPOSE: Whether therapeutic hypothermia (TH) adds to the risk of bleeding in patients on extracorporeal life support (ECLS) peri-cardiac arrest remains unknown.MATERIAL AND METHODS: Single center retrospective study on patients receiving veno-arterial ECLS peri-cardiac arrest ± TH at 32-34 °C (January 2009-December 2015).PRIMARY OUTCOME: major bleeding (including intracerebral hemorrhage, ICH) < 72 h of cardiac arrest. Logistic regression and marginal structural models were used to analyze associations with major bleeding.RESULTS: Of 66 patients receiving ECLS, 36 were treated with TH. Major bleeding occurred in 14 patients (39%) treated with ECLS+TH and in 17 patients (57%) with ECLS alone. ICH was reported in 3 (8%) and one patient (3%), respectively. There was no difference in mortality, but lung injury occurred more often in ECLS+TH. A platelet count <60 × 109/L but not TH was associated with major bleeding (including ICH). The estimated causal risk ratio of TH on the occurrence of major bleeding (including ICH) at 72 h post cardiac arrest was 0.95 (95%CI 0.62-1.45).CONCLUSIONS: Bleeding complications were common in our study. However, TH (32-34 °C) was not associated with an increased risk of major bleeding in patients on ECLS peri-cardiac arrest.
AB - PURPOSE: Whether therapeutic hypothermia (TH) adds to the risk of bleeding in patients on extracorporeal life support (ECLS) peri-cardiac arrest remains unknown.MATERIAL AND METHODS: Single center retrospective study on patients receiving veno-arterial ECLS peri-cardiac arrest ± TH at 32-34 °C (January 2009-December 2015).PRIMARY OUTCOME: major bleeding (including intracerebral hemorrhage, ICH) < 72 h of cardiac arrest. Logistic regression and marginal structural models were used to analyze associations with major bleeding.RESULTS: Of 66 patients receiving ECLS, 36 were treated with TH. Major bleeding occurred in 14 patients (39%) treated with ECLS+TH and in 17 patients (57%) with ECLS alone. ICH was reported in 3 (8%) and one patient (3%), respectively. There was no difference in mortality, but lung injury occurred more often in ECLS+TH. A platelet count <60 × 109/L but not TH was associated with major bleeding (including ICH). The estimated causal risk ratio of TH on the occurrence of major bleeding (including ICH) at 72 h post cardiac arrest was 0.95 (95%CI 0.62-1.45).CONCLUSIONS: Bleeding complications were common in our study. However, TH (32-34 °C) was not associated with an increased risk of major bleeding in patients on ECLS peri-cardiac arrest.
U2 - 10.1016/j.jcrc.2020.11.008
DO - 10.1016/j.jcrc.2020.11.008
M3 - SCORING: Journal article
C2 - 33227591
VL - 62
SP - 12
EP - 18
JO - J CRIT CARE
JF - J CRIT CARE
SN - 0883-9441
ER -
