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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

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

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  • Media type: E-Article
  • Title: 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
  • Contributor: 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
  • Published: MDPI AG, 2021
  • Published in: Journal of Clinical Medicine, 10 (2021) 10, Seite 2158
  • Language: English
  • DOI: 10.3390/jcm10102158
  • ISSN: 2077-0383
  • Origination:
  • Footnote:
  • Description: <jats:p>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 &lt; 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.</jats:p>
  • Access State: Open Access