Vos, P.P.W.K.(Peter-Paul) (2019) Poor coagulation management during Extra Corporeal Life Support. thesis, Medicine.
Full text available on request.Abstract
Extracorporeal Life Support (ECLS) is a form of cardiopulmonary support which can be offered to patients on the ICU for a period of days to weeks. ECLS is establishing itself as the standard of care rescue therapy in critically ill patients with severe cardio-respiratory failure.1 ECLS therapy is a high risk therapy and the incidence of complications is significant. Haemorrhage requiring an intervention is the most frequent complication with an incidence in literature of 10-30%2. ECLS hardware (cannulas, pump and oxygenator) can influence platelet function, platelet aggregation and therefore cause bleeding complications.3 No consensus is reached regarding coagulation parameters best in predicting and preventing coagulation disorders and subsequently the risk of bleeding during ECLS.4 Material and Methods This retrospective, single centre study analysed predictors of bleeding in 144 patients treated with VV-VA ECLS. Results Post-cardiotomy patients show to be at high risk of developing bleeding and have the property of low platelet counts. We demonstrate that current coagulation parameters have no independent association with the occurrence of bleeding during ECLS. In addition, a disassociation between aPTT-ratio and UFH infusion is observed over time. Conclusions These findings primarily raise questions in the reliability of current static coagulation parameters, especially aPTT-ratio in representing coagulation and determining UFH infusion. Secondarily, in questioning the use of UFH as a main anticoagulant during ECLS. Achtergrond
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Oude Lansink-Hartgring, drs. A. |
| Supervisor name: | Scholten,, drs. E. |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Oct 2020 12:05 |
| Last Modified: | 02 Oct 2020 12:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2770 |
Actions (login required)
 |
View Item |