Table 1 Comparison of ECMO episodes with and without bleeding events
From: Predictive factors of bleeding events in adults undergoing extracorporeal membrane oxygenation
Variable | All episodes (n = 149) | No bleeding (n = 60) | Bleeding (n = 89) | P |
|---|---|---|---|---|
Age (year ± SD) | 46.5 ± 14.9 | 44.5 ± 15.1 | 47.8 ± 14.7 | 0.18 |
Male sex | 92 (62 %) | 38 (63 %) | 54 (61 %) | 0.74 |
Weight (kg ± SD) | 80.7 ± 22 | 80.7 ± 22 | 80.7 ± 22 | 1.00 |
APACHE III score ± SD | 77.3 ± 33.6 | 70.1 ± 30 | 82.1 ± 35.2 | 0.03 |
Comorbidities | ||||
Immunosuppressed | 34 (23 %) | 8 (14 %) | 26 (29 %) | 0.027 |
Hepatic failure | 3 (2 %) | 2 (3 %) | 1 (1 %) | 0.34 |
Cirrhosis liver disease | 2 (1.3 %) | 0 (0 %) | 2 (2 %) | 0.25 |
Insulin dependent diabetes | 7 (5 %) | 3 (5 %) | 4 (5 %) | 0.87 |
Chronic respiratory failure | 23 (16 %) | 4 (7 %) | 19 (21 %) | 0.018 |
Chronic cardiovascular disease | 38 (26 %) | 14 (24 %) | 24 (27 %) | 0.66 |
Chronic renal failure | 2 (1.3 %) | 0 (0 %) | 2 (2 %) | 0.25 |
Indications for ECMO | ||||
Acute cardiomyopathy | 20 (13 %) | 12 (20 %) | 8 (9 %) | 0.05 |
AMI | 28 (19 %) | 9 (15 %) | 19 (21 %) | 0.33 |
Chronic cardiomyopathy | 14 (9 %) | 8 (13 %) | 6 (7 %) | 0.18 |
Heart transplant | 16 (11 %) | 4 (7 %) | 12 (13 %) | 0.19 |
Lung transplant | 15 (10 %) | 3 (5 %) | 12 (13 %) | 0.09 |
Pneumonia | 27 (18 %) | 16 (27 %) | 11 (12 %) | 0.03 |
Post CAGS or valve surgery | 9 (6 %) | 1 (2 %) | 8 (9 %) | 0.07 |
Other | 20 (13 %) | 7 (12 %) | 13 (15 %) | 0.61 |
Post-surgical ECMO | 39 (26 %) | 4 (7 %) | 35 (39 %) | <0.001 |
Transplantation prior | 33 (22 %) | 8 (13 %) | 25 (28 %) | 0.033 |
Cardiac arrest before | 39 (26 %) | 14 (23 %) | 25 (28 %) | 0.52 |
Medication prior ECMO | ||||
Aspirin | 35 (24 %) | 13 (22 %) | 22 (26 %) | 0.59 |
Clopidogrel | 17 (12 %) | 5 (8 %) | 12 (14 %) | 0.32 |
Warfarin | 16 (11 %) | 4 (7 %) | 12 (14 %) | 0.16 |
ECMO started in another hospital | 40 (27 %) | 20 (33 %) | 20 (22 %) | 0.14 |
ECMO type | ||||
VA ECMO | 111 (74 %) | 40 (67 %) | 71 (80 %) | 0.07 |
VV ECMO | 38 (26 %) | 20 (33 %) | 18 (20 %) | 0.07 |
Days on support, median [IQR] | 7 [5–11] | 6 [5–10] | 8 [5–12] | 0.09 |
Centre Alfred Hospital | 128 (86 %) | 52 (87 %) | 76 (85 %) | 0.83 |
RRT at any time | 60 (43 %) | 18 (31 %) | 42 (51 %) | 0.02 |
MV at any time | 145 (97 %) | 57 (95 %) | 88 (99 %) | 0.15 |
SOFA score prior ECMO median [IQR] | ||||
Total | 10 [7–13] | 9 [7–12] | 11 [9–14] | 0.01 |
SOFA respiratory | 3 [2–4] | 3 [2– 4] | 3 [1–4] | 0.95 |
SOFA coagulation | 0 [0–1] | 0 [0–1] | 1 [0–2] | 0.17 |
SOFA liver | 0 [0–2] | 0 [0–1] | 1 [0–2] | 0.02 |
SOFA cardiovascular | 4 [4–4] | 4 [3–4] | 4 [4–4] | 0.02 |
SOFA neurology | 1 [0–2] | 0 [0–1] | 1 [0–3] | 0.02 |
SOFA renal | 1 [0–3] | 1 [0– 2] | 1 [0–3] | 0.21 |
Blood product use during ECMO | ||||
Median RBC unit (IQR) | 6 [2–14] | 2 [0.5–4] | 12 [6–19] | <0.01 |
Median PLT doses (IQR) | 1 [0–3] | 0 [0–1] | 2 [0–5] | <0.01 |
Median FFP unit (IQR) | 2 [0–6] | 0 [0–1] | 5 [1–10] | <0.01 |
Median cryoprecipitate (IQR) | 0 [0–0] | 0 [0–0] | 0 [0–1] | <0.01 |
Other adverse events | ||||
Ischaemic stroke | 4 (2.7 %) | 1 (2 %) | 3 (3 %) | 0.53 |
Membrane change | 16 (11 %) | 6 (10 %) | 10 (11 %) | 0.81 |
Limb ischaemia any stage | 11 (7 %) | 2 (3 %) | 9 (10 %) | 0.12 |
Outcomes | ||||
Weaned off ECMO | 95 (64 %) | 42 (70 %) | 53 (60 %) | 0.19 |
Never weaned | 36 (24 %) | 10 (17 %) | 26 (29 %) | 0.08 |
Bridge to other assistance | 18 (12 %) | 8 (13 %) | 10 (11 %) | 0.70 |
Median (IQR) ICU LOS (days) | 17 [9–28] | 13.5 [8–23] | 16 [9–28] | 0.18 |
Median (IQR) hospital LOS (days) | 36.5 [15–56] | 27.5 [13.5–36.5] | 36.5 [15–56] | 0.04 |
ICU status, alive | 101 (68 %) | 45 (75 %) | 56 (63 %) | 0.12 |
Hospital status, alive | 99 (66 %) | 45 (75 %) | 54 (61 %) | 0.07 |
Discharge home | 65 (66 %) | 33 (55 %) | 32 (36 %) | 0.02 |