1. Evaluation of Anti-Activated Factor X Activity and Activated Partial Thromboplastin Time Relations and Their Association with Bleeding and Thrombosis during Veno-Arterial ECMO Support: A Retrospective Study.
- Author
-
Moussa, Mouhamed Djahoum, Soquet, Jérôme, Lamer, Antoine, Labreuche, Julien, Gantois, Guillaume, Dupont, Annabelle, Abou-Arab, Osama, Rousse, Natacha, Liu, Vincent, Brandt, Caroline, Foulon, Valentin, Leroy, Guillaume, Schurtz, Guillaume, Jeanpierre, Emmanuel, Duhamel, Alain, Susen, Sophie, Vincentelli, André, Robin, Emmanuel, Biswas, Arijit, and Wada, Hideo
- Subjects
- *
PARTIAL thromboplastin time , *EXTRACORPOREAL membrane oxygenation , *HEMORRHAGE , *THROMBOSIS , *CARDIOGENIC shock , *ADULTS - Abstract
Background: We aimed to investigate the relationship between anti-activated Factor X (anti-FXa) and activated Partial Thromboplastin Time (aPTT), and its modulation by other haemostasis co-variables during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. We further investigated their association with serious bleeding and thrombotic complications. Methods: This retrospective single-center study included 265 adults supported by VA-ECMO for refractory cardiogenic shock from January 2015 to June 2019. The concordance of anti-FXa and aPTT and their correlations were assessed in 1699 paired samples. Their independent associations with serious bleeding or thrombotic complications were also analysed in multivariate analysis. Results: The concordance rate of aPTT with anti-FXa values was 50.7%, with 39.3% subtherapeutic aPTT values. However, anti-FXa and aPTT remained associated (β = 0.43 (95% CI 0.4–0.45) 10−2 IU/mL, p < 0.001), with a significant modulation by several biological co-variables. There was no association between anti-FXa nor aPTT values with serious bleeding or with thrombotic complications. Conclusion: During VA-ECMO, although anti-FXa and aPTT were significantly associated, their values were highly discordant with marked sub-therapeutic aPTT values. These results should favour the use of anti-FXa. The effect of biological co-variables and the failure of anti-FXa and aPTT to predict bleeding and thrombotic complications underline the complexity of VA-ECMO-related coagulopathy. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF