Abstract
Introduction: In patients with septic shock on extracorporeal membrane oxygenation (ECMO) support, data on change of coagulation profiles and impact of disseminated intravascular coagulation (DIC) on hospital outcomes are very limited.
Objectives: To investigate the evolution of coagulation profiles during the 72-h ECMO support and to investigate the impact of the DIC score on hospital outcomes.
Methods: A retrospective review of adult patients with septic shock who received ECMO support at two university-affiliated hospitals. The International Society of Thrombosis and Haemostasis (ISTH) criteria for DIC were used.
Results: In total, 37 patients treated with ECMO (venoarterial, 26; venovenous, 8; other types, 3) were included in this study (mean age, 49.0 yrears). The most common cause of septic shock was pneumonia (n = 16), and nineteen patients had received cardiac pulmonary resuscitation before the ECMO. During the first 72 hours, as well as DIC score, platelet, prothrombin time, D-dimer and antithrombin-III levels were significantly different between survivors and nonsurvivors. In ROC curve, pre-ECMO DIC score had a good discriminating power for hospital death (value of area under the curve, 0.815). Patients with overt DIC (pre-ECMO) received more transfusions, and in multivariate analysis, pre-ECMO DIC score was a significant factor for hospital death (odds ratio, 5.116; 95% confidence interval, 1.368-10.124).
Conclusions: During the first 72hrs ECMO support, coagulation profiles were significantly different between survivors and nonsurvivors and pre-ECMO DIC score might be a risk factor for hospital death in patients with septic shock on ECMO support.
- Copyright ©the authors 2016
