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Disseminated intravascular coagulation profiles in patients with septic shock on ECMO

Sunghoon Park, Dong-Gyu Kim, Dae-Young Cheon, Hyoung Soo Kim, Sun Hee Lee
European Respiratory Journal 2016 48: PA3569; DOI: 10.1183/13993003.congress-2016.PA3569
Sunghoon Park
1Pulmonary, Allergy and Critical Care, Hallym University Sacred Heart Hospital, Anyang, GyeonggiRepublic of Korea
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Dong-Gyu Kim
2Pulmonary, Allergy and Critical Care, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
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Dae-Young Cheon
1Pulmonary, Allergy and Critical Care, Hallym University Sacred Heart Hospital, Anyang, GyeonggiRepublic of Korea
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Hyoung Soo Kim
3Cardiothoracic Surgery, Hallym University Sacred Heart Hospital, Anyang, GyeonggiRepublic of Korea
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Sun Hee Lee
3Cardiothoracic Surgery, Hallym University Sacred Heart Hospital, Anyang, GyeonggiRepublic of Korea
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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.

  • Sepsis
  • Acute respiratory failure
  • Circulation
  • Copyright ©the authors 2016
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Disseminated intravascular coagulation profiles in patients with septic shock on ECMO
Sunghoon Park, Dong-Gyu Kim, Dae-Young Cheon, Hyoung Soo Kim, Sun Hee Lee
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3569; DOI: 10.1183/13993003.congress-2016.PA3569

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Disseminated intravascular coagulation profiles in patients with septic shock on ECMO
Sunghoon Park, Dong-Gyu Kim, Dae-Young Cheon, Hyoung Soo Kim, Sun Hee Lee
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3569; DOI: 10.1183/13993003.congress-2016.PA3569
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