Acquired von Willebrand syndrome in ECMO patients: A 3-year cohort study
Standard
Acquired von Willebrand syndrome in ECMO patients: A 3-year cohort study. / Panholzer, Bernd; Bajorat, Tido; Haneya, Assad; Kowalski, Dorothee; Juhl, David; Rocke, Angela; Shneyder, Maria; Kuta, Piotr; Clausnizer, Hartmut; Junker, Ralf; Kowalski, Arne; Tulun, Aysun; Al-Suraimi, Akram; Cremer, Jochen; Kalbhenn, Johannes; Zieger, Barbara; Nowak-Göttl, Ulrike.
In: BLOOD CELL MOL DIS, Vol. 87, 03.2021, p. 102526.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Acquired von Willebrand syndrome in ECMO patients: A 3-year cohort study
AU - Panholzer, Bernd
AU - Bajorat, Tido
AU - Haneya, Assad
AU - Kowalski, Dorothee
AU - Juhl, David
AU - Rocke, Angela
AU - Shneyder, Maria
AU - Kuta, Piotr
AU - Clausnizer, Hartmut
AU - Junker, Ralf
AU - Kowalski, Arne
AU - Tulun, Aysun
AU - Al-Suraimi, Akram
AU - Cremer, Jochen
AU - Kalbhenn, Johannes
AU - Zieger, Barbara
AU - Nowak-Göttl, Ulrike
N1 - Copyright © 2020. Published by Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - BACKGROUND: Bleeding is a common but possibly underreported side effect of Extracorporeal Membrane Oxygenation (ECMO). Impairment of primary hemostasis by acquired von Willebrand syndrome (aVWS) and platelet dysfunction as well as activation and consumption of plasmatic coagulation factors contribute to hemorrhage. The aim of the present cohort study of consecutively enrolled patients admitted to our ECMO center was to collect demographic, medical and laboratory data possibly associated with i) development of clinically relevant bleeding and/or ii) death during a 12-months follow-up.RESULTS: Within a 3-year period 338 white patients aged 18-89 years (median: 60; male 64.5%) were enrolled. 78 of 338 patients (23%) presented with clinical relevant bleeding symptoms. The overall death rate was 74.6% within a median time of 9 days (1-229) post intervention. Logistic-regression analysis adjusted for age and gender revealed that i) the presence of blood group O versus non-O (Odds ratio (OR)/95%CI: 1.9/1.007-3.41), ECMO duration per day (1.1/1.06-1.14), veno-venous versus veno-arterial ECMO cannulation (2.33/1.2-4.5) and the overall need for blood product administered per unit (1.02/1.016-1.028) was independenly associated with bleeding in patients suffering from aVWS. ii) Older age (increase per year) at ECMO start (1.015/1.012-1.029) and an increasing amount of blood product units were significantly related with death (1.007/1.001-1.013). Patients with veno-venous versus veno-arterial cannulation survived longer (0.48/0.24-0.94).CONCLUSION: In the present cohort study we found a clinical relevant bleeding rate of 23% in subjects with aVWS associated with blood group O, a longer ECMO duration and veno-venous cannulation.
AB - BACKGROUND: Bleeding is a common but possibly underreported side effect of Extracorporeal Membrane Oxygenation (ECMO). Impairment of primary hemostasis by acquired von Willebrand syndrome (aVWS) and platelet dysfunction as well as activation and consumption of plasmatic coagulation factors contribute to hemorrhage. The aim of the present cohort study of consecutively enrolled patients admitted to our ECMO center was to collect demographic, medical and laboratory data possibly associated with i) development of clinically relevant bleeding and/or ii) death during a 12-months follow-up.RESULTS: Within a 3-year period 338 white patients aged 18-89 years (median: 60; male 64.5%) were enrolled. 78 of 338 patients (23%) presented with clinical relevant bleeding symptoms. The overall death rate was 74.6% within a median time of 9 days (1-229) post intervention. Logistic-regression analysis adjusted for age and gender revealed that i) the presence of blood group O versus non-O (Odds ratio (OR)/95%CI: 1.9/1.007-3.41), ECMO duration per day (1.1/1.06-1.14), veno-venous versus veno-arterial ECMO cannulation (2.33/1.2-4.5) and the overall need for blood product administered per unit (1.02/1.016-1.028) was independenly associated with bleeding in patients suffering from aVWS. ii) Older age (increase per year) at ECMO start (1.015/1.012-1.029) and an increasing amount of blood product units were significantly related with death (1.007/1.001-1.013). Patients with veno-venous versus veno-arterial cannulation survived longer (0.48/0.24-0.94).CONCLUSION: In the present cohort study we found a clinical relevant bleeding rate of 23% in subjects with aVWS associated with blood group O, a longer ECMO duration and veno-venous cannulation.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Blood Transfusion
KW - Cohort Studies
KW - Extracorporeal Membrane Oxygenation/adverse effects
KW - Female
KW - Follow-Up Studies
KW - Hemorrhage/etiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Risk Factors
KW - Treatment Outcome
KW - Young Adult
KW - von Willebrand Diseases/complications
U2 - 10.1016/j.bcmd.2020.102526
DO - 10.1016/j.bcmd.2020.102526
M3 - SCORING: Journal article
C2 - 33338698
VL - 87
SP - 102526
JO - BLOOD CELL MOL DIS
JF - BLOOD CELL MOL DIS
SN - 1079-9796
ER -
