1. Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients
- Author
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Konrad Hoetzenecker, André Pausch, Marion Wiegele, Friedrich Erhart, Peter Jaksch, Eva Schaden, Johannes Gratz, and Andreas Baierl
- Subjects
Male ,medicine.medical_treatment ,Medicine (miscellaneous) ,02 engineering and technology ,030204 cardiovascular system & hematology ,Single Center ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,anticoagulation ,low molecular weight heparin ,General Medicine ,Middle Aged ,medicine.anatomical_structure ,surgical procedures, operative ,Treatment Outcome ,Anesthesia ,Female ,Adult ,medicine.drug_class ,unfractioned heparin ,0206 medical engineering ,Biomedical Engineering ,Low molecular weight heparin ,alternative anticoagulants ,Bioengineering ,Postoperative Hemorrhage ,Drug Administration Schedule ,Perioperative Care ,Biomaterials ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,Main Text Articles ,Thromboembolism ,Extracorporeal membrane oxygenation ,lung transplantation ,Lung transplantation ,Humans ,Blood Coagulation ,Retrospective Studies ,Lung ,Main Text Article ,Dose-Response Relationship, Drug ,business.industry ,Heparin ,Unfractioned heparin ,Anticoagulants ,Perioperative ,Heparin, Low-Molecular-Weight ,020601 biomedical engineering ,business - Abstract
Extracorporeal membrane oxygenation (ECMO) is gaining importance in the perioperative management of lung transplant patients. To date, the ideal substance for anticoagulation of ECMO patients is still a matter of debate. In this study, we describe our experience with the use of low molecular weight heparin (LMWH) in comparison with unfractioned heparin (UFH) in lung transplant patients undergoing perioperative ECMO support. We retrospectively analyzed data from all lung transplant patients who underwent perioperative ECMO support at our institution between 2013 and 2017. Bleeding events served as primary outcome parameter. Secondary outcome parameters consisted of thromboembolic events. 102 patients were included in this study, of which 22 (21.6%) received UFH for anticoagulation, and 80 (78.4%) received LMWH. There was no difference between the two groups in regard to serious bleeding events (22.7% in the UFH group vs 12.5% in the LMWH group, P = .31). However, the proportion of patients experiencing thromboembolic events was significantly higher in the UFH group than in the LMWH group (50% vs 20%, P = .01). After adjusting for baseline differences between the two groups, we still observed a difference with respect to thromboembolic events. These data remain to be validated in future prospective, randomized trials.
- Published
- 2019