Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Risk Factors of Cannula-associated Arterial Thrombosis following Extracorporeal Membrane Oxygenation support: A Retrospective Study

Ngan Hoang Kim Trieu
* ,
Xuan Thi Phan
,
Linh Thanh Tran
,
Huy Minh Pham
ORCID logo ,
Dai Quang Huynh
ORCID logo ,
Tuan Manh Nguyen
,
Anh Tuan Mai
ORCID logo ,
Quan Quoc Minh Du
,
Bach Xuan Nguyen
,
Thao Thi Ngoc Pham
ORCID logo
Version 1 : Received: 23 January 2023 / Approved: 26 January 2023 / Online: 26 January 2023 (08:33:01 CET)

A peer-reviewed article of this Preprint also exists.

Trieu, N.H.K.; Phan, X.T.; Tran, L.T.; Pham, H.M.; Huynh, D.Q.; Nguyen, T.M.; Mai, A.T.; Du, Q.Q.M.; Nguyen, B.X.; Pham, T.T.N. Risk Factors for Cannula-Associated Arterial Thrombosis Following Extracorporeal Membrane Oxygenation Support: A Retrospective Study. Acute and Critical Care 2023, doi:10.4266/acc.2023.00500. Trieu, N.H.K.; Phan, X.T.; Tran, L.T.; Pham, H.M.; Huynh, D.Q.; Nguyen, T.M.; Mai, A.T.; Du, Q.Q.M.; Nguyen, B.X.; Pham, T.T.N. Risk Factors for Cannula-Associated Arterial Thrombosis Following Extracorporeal Membrane Oxygenation Support: A Retrospective Study. Acute and Critical Care 2023, doi:10.4266/acc.2023.00500.

Abstract

Introduction: Hemostatic dysfunction during extracorporeal membrane oxygenation (ECMO) due to blood-circuit interaction and the consequences of shear stress by flow rates lead to rapid activation of the coagulation cascade and thrombus formation in the ECMO system and blood vessels. In this study, we aimed to identify the incidence and risk factors for cannula-associated arterial thrombosis (CaAT) post-decannulation. Methods: A retrospective study of patients undergoing arterial cannula removal following ECMO. We evaluated the incidence of CaAT and compared clinical characteristics, pre-ECMO severity, and daily hemostasis parameters in patients with and without CaAT. Multivariate analysis revealed the risk factors for CaAT. Results: Forty-seven patients requiring venoarterial ECMO or hybrid methods were recruited to be screened for thrombosis. The median SOFA score was 11 (8-13). CaAT occurred in 29 patients (61.7%), with thrombosis in the superficial femoral artery accounting for 51.7%. Limb ischemia complications in the group with CaAT was 17.2%. In multivariate analysis, an ECMO flow rate of 100 mL/min was determined to be the independent factor for CaAT with an OR of 0.84 (95% CI, 0.73–0.95, p=0.008). Conclusion: In patients successfully weaned from ECMO, the incidence of CaAT was 61.7%. Our study found that a low-flow rate of ECMO was an independent risk factor for CaAT.

Keywords

extracorporeal membrane oxygenation; cannula-associated arterial thrombosis; flow rate

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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