Decreased maximum clot firmness in rotational thromboelastometry (ROTEM (R)) is associated with bleeding during extracorporeal mechanical circulatory support

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Laine , A , Niemi , T , Suojaranta-Ylinen , R , Raivio , P , Soininen , L , Lemstrom , K , Hammainen , P & Schramko , A 2016 , ' Decreased maximum clot firmness in rotational thromboelastometry (ROTEM (R)) is associated with bleeding during extracorporeal mechanical circulatory support ' , Perfusion , vol. 31 , no. 8 , pp. 625-633 . https://doi.org/10.1177/0267659116647473

Title: Decreased maximum clot firmness in rotational thromboelastometry (ROTEM (R)) is associated with bleeding during extracorporeal mechanical circulatory support
Author: Laine, Antti; Niemi, Tomi; Suojaranta-Ylinen, Raili; Raivio, Peter; Soininen, Leena; Lemstrom, Karl; Hammainen, Pekka; Schramko, Alexey
Contributor: University of Helsinki, Clinicum
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
University of Helsinki, Department of Surgery
University of Helsinki, Anestesiologian yksikkö
Date: 2016-11
Language: eng
Number of pages: 9
Belongs to series: Perfusion
ISSN: 0267-6591
URI: http://hdl.handle.net/10138/230027
Abstract: Background: We aimed to characterize the coagulation disturbances which may increase the risk of bleeding, thrombosis or death shortly after implantation of an extracorporeal membrane oxygenation (ECMO) or ventricular assist (VAD) device. Methods: Antithrombotic treatment was started in 23 VAD and 24 ECMO patients according to the hospital protocol. Additionally, conventional laboratory testing, rotational thromboelastometry (ROTEM (R)) and platelet function analysis (Multiplate) were performed at predetermined intervals. Results: Four out of twenty-four (16.7%) of ECMO patients and 6/23 (26.1%) of VAD patients had severe bleeding after the procedure. When all the patients were analyzed together, low maximum clot firmness (MCF) in ExTEM and FibTEM analyses was associated with severe bleeding (p Conclusion: Hypocoagulation shown by ROTEM (R) was associated with bleeding complications in patients with mechanical circulatory support. In contrast, hypercoagulation did not correlate with clinical thrombosis.
Subject: ECMO
VAD
coagulation
bleeding
thrombosis
MEMBRANE-OXYGENATION
FLUID BALANCE
COAGULATION
IMPACT
BYPASS
ANTICOAGULATION
METAANALYSIS
THERAPY
SURGERY
HEPARIN
3126 Surgery, anesthesiology, intensive care, radiology
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