Incidence and risk factors of deep vein thrombosis after extracorporeal life support. Issue 9 (29th April 2022)

• Record Type: Journal Article
• Authors: van Minnen, Olivier; van den Bergh, Walter M.; Droogh, Joep M.; Koehorst, Lisette; Lagrand, Wim K.; Raasveld, S. Jorinde; Oude Lansink‐Hartgring, Annemieke; Terpstra, Aart; Smit, Jasper M.; Tuinman, Pieter R.; Vlaar, Alexander P. J.
• Is Part Of: Artificial organs. Volume 46:Issue 9(2022)
• Page Start: 1893
• Page End: 1900
• Publication Date: 2022-04-29
• Subjects: anticoagulant -- deep vein thrombosis -- extracorporeal life support; Artificial organs -- Periodicals; 617.956
• DOI: 10.1111/aor.14271
• Languages: English
• ISSNs: 0160-564X

Abstract

Abstract: Background: Deep vein thrombosis (DVT) after decannulation of extracorporeal life support (ECLS) is not uncommon. Moreover, the impact of anticoagulation and potential risk factors is unclear. Furthermore, it is unclear if cannula‐associated DVT is more common in ECLS patients compared to critically ill patients without ECLS. Methods: All adult patients who were successfully weaned from ECLS and were screened for DVT following decannulation were included in this observational cohort study. The incidence of post‐ECLS‐DVT was assessed and the cannula‐associated DVT rate was compared with that of patients without ECLS after central venous catheter (CVC) removal. The correlation between the level of anticoagulation, risk factors, and post‐ECLS‐DVT was determined. Results: We included 30 ECLS patients and 53 non‐ECLS patients. DVT was found in 15 patients (50%) of which 10 patients had a DVT in a cannulated vein. No correlation between the level of anticoagulation and DVT was found. V‐V ECLS mode was the only independent risk factor for post‐ECLS‐DVT (OR 5.5; 95%CI 1.16–26.41). We found no difference between the ECLS and non‐ECLS cohorts regarding cannula‐associated DVT rate (33% vs. 32%). Conclusion: Post‐ECLS‐DVT is a common finding that occurs in half of all patients supported with ECLS. The incidence of cannula‐associated DVT was equal to CVC‐associated DVT in critically ill patients without ECLS. V‐V ECLS was an independent risk factor for post‐ECLS‐DVT. Abstract : DVT following ECLS is frequent with half the patients showing DVT after decannulation. However, similar cannula‐associated DVT rates in ECLS patients compared to CVC‐associated DVT rates in a non‐ECLS cohort of critically ill patients were found. We identified V‐V ECLS as an independent risk factor for post‐ECLS‐DVT. The level of anticoagulation based on aPTT values was not associated with the occurrence of post‐ECLS‐DVT. Further research is needed to reveal the clinical relevance of post‐ECLS‐DVT and factors associated with cannula‐associated DVT.