Major Bleeding in Adults Undergoing Peripheral Extracorporeal Membrane Oxygenation (ECMO): Prognosis and Predictors
Table 1
Clinical characteristics of ECMO patients with and without major bleeding.
Characteristics
All patients (n = 105)
Patients with major bleeding (n = 33)
Patients without major bleeding (n = 72)
Age (yrs)
39 [30; 52]
39 [30; 54]
40 [31; 51]
0.923
Gender, male
51 (48.5)
13 (39.4)
38 (52.8)
0.287
BMI
Comorbidities
Hypertension
9 (8.5)
3 (9.0)
6 (8.3)
0.12
Diabetes mellitus
2 (1.9)
0 (0)
2 (0)
Coronary artery disease
2 (1.9)
1 (0.95)
1 (0.95)
Coagulation disorder
0 (0)
0 (0)
0 (0)
Malignancy
0 (0)
0 (0)
0 (0)
Gastroduodenal ulcer
1 (0.95)
0 (0)
1 (0.95)
Diagnosis
Acute myocarditis
42 (40.0)
14 (42.4)
28 (38.9)
0.352
ARDS
40 (38.1)
9 (27.2)
31 (43.1)
AMI
12 (11.4)
5 (15.2)
7 (9.7)
Others
11 (10.5)
5 (15.2)
6 (8.3)
ECMO indications
Cardiac
60 (57.1)
22 (66.7)
38 (55.5)
0.081
Pulmonary
44 (41.9)
10 (30.3)
34 (47.2)
ECPR
1 (1.0)
1 (3.0)
0 (0.0)
ECMO modalities
VA
61 (58.1)
23 (69.7)
38 (52.8)
0.238
VV
38 (36.2)
8 (24.2)
30 (41.7)
VAV
6 (5.7)
2 (6.1)
4 (5.5)
Pre-ECMO APACHE-II score
20 [15; 25]
22 [19; 26]
19 [15; 23]
0.163
Pre-ECMO SOFA score
11 [9; 13]
11 [10; 14]
11 [9; 13]
0.550
Pre-ECMO cardiac arrest
13 (12.3)
6 (18.2)
7 (9.7)
0.337
Coagulation profile
Platelet count (× 109/L)
190 [117; 258]
142 [68; 246]
198 [139; 258]
0.037
INR
1.4 [1.1; 1.6]
1.4 [1.2; 2.4]
1.3 [1.1; 1.5]
0.09
APTT (s)
39 [30; 55]
42 [36; 61]
36 [29; 54]
0.04
Fibrinogen (g/L)
3.5 [3.4; 4.1]
3.5 [2.7; 4.9]
3.7 [2.5; 4.5]
0.82
Blood products transfusion during ECMO
RBC (ml)
126 [58–230]
230 [131–245]
101 [44–126]
<0.001
PLT (ml)
31 [0–137]
167 [45–321]
0 [0–44]
<0.001
FFP + cry (units)
2 [1; 8]
8 [4; 14]
0 [0; 4]
<0.001
ECMO complications
Nosocomial infections
42 (40.0)
17/33 (51.5)
25 (34.7)
0.159
AKI
77 (73.3)
23/33 (69.4)
59 (81.8)
0.270
Outcomes
Successful ECMO weaning
81 (77)
20 (60)
61 (85)
0.013
ECMO mortality
24 (22.8)
13 (39.4)
11 (15.3)
0.013
ICU mortality
29 (27.6)
16 (48.4)
13 (18.0)
0.002
In-hospital mortality
30 (28.6)
17 (51.5)
13 (18)
<0.001
Data are presented as n (%) categorical variables and median (interquartile range) for nonparametric variables. ARDS, acute respiratory distress syndrome; AMI, acute myocardial infarction; RBC, red blood cell; PLT, platelet count; FFP, fresh frozen plasma; Cry, cryoprecipitate; AKI, acute kidney injury was defined by KDIGO criteria; ECMO, extracorporeal membrane oxygenation.
