A Comparison of Thrombosis and Hemorrhage Rates in Patients With Severe Respiratory Failure Due to Coronavirus Disease 2019 and Influenza Requiring Extracorporeal Membrane Oxygenation.

Extracorporeal membrane oxygenation is a lifesaving therapy for patients with severe acute respiratory distress syndrome refractory to conventional mechanical ventilation. It is frequently complicated by both thrombosis and hemorrhage. A markedly prothrombotic state associated with high rates of venous thromboembolism has been described in patients with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) infection. These rates have currently not been described during extracorporeal membrane oxygenation in comparison to other viral pneumonias. Retrospective observational study. Single high-volume tertiary critical care department at a university hospital. Patients 16 years old or greater receiving venovenous extracorporeal membrane oxygenation between March 1, 2020, and May 31, 2020, with coronavirus disease 2019 were compared with a cohort of patients with influenza pneumonia between June 1, 2012, and May 31, 2020. None. The rates of venous thromboembolism and hemorrhage were compared in patients with coronavirus disease 2019 against a historic population of patients with influenza pneumonia who required extracorporeal membrane oxygenation. There were 51 patients who received extracorporeal membrane oxygenation due to coronavirus disease 2019 and 80 patients with influenza. At cannulation for extracorporeal membrane oxygenation, 37% of patients with coronavirus disease 2019 compared with 8% of patients with influenza had filling defects on CT pulmonary angiography (p = 0.0001). Catheter-associated deep vein thrombosis shown on ultrasound Doppler after decannulation was present in 53% with coronavirus disease 2019 versus 25% with influenza (p = 0.01). The rates of intracranial hemorrhage at the time of cannulation were 16% with coronavirus disease 2019 and 14% with influenza (p = 0.8). Elevated d-dimer levels were seen in both conditions and were significantly higher in those with pulmonary thromboembolism than those without in coronavirus disease 2019 (p = 0.02). Fibrinogen and C-reactive protein levels were significantly higher in those with coronavirus disease 2019 than influenza (p < 0.01). Significant rates of pulmonary thromboembolism and of catheter-associated deep vein thrombosis were seen in both viral infections but were greater in those requiring the use of extracorporeal membrane oxygenation in coronavirus disease 2019 than for influenza.

Doyle AJ ，Hunt BJ ，Sanderson B ，Zhang J ，Mak SM ，Benedetti G ，Breen KA ，Camporota L ，Barrett NA ，Retter A ... -  《-》

Venous Thromboembolism Events Following Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Syndrome Coronavirus 2 Based on CT Scans.

Parzy G ，Daviet F ，Puech B ，Sylvestre A ，Guervilly C ，Porto A ，Hraiech S ，Chaumoitre K ，Papazian L ，Forel JM ... -  《-》

Prevalence and Risk Factors for Thrombotic Complications Following Venovenous Extracorporeal Membrane Oxygenation: A CT Scan Study.

Parzy G ，Daviet F ，Persico N ，Rambaud R ，Scemama U ，Adda M ，Guervilly C ，Hraiech S ，Chaumoitre K ，Roch A ，Papazian L ，Forel JM ... -  《-》

Computed tomography characterization and outcome evaluation of COVID-19 pneumonia complicated by venous thromboembolism.

Meiler S ，Hamer OW ，Schaible J ，Zeman F ，Zorger N ，Kleine H ，Rennert J ，Stroszczynski C ，Poschenrieder F ... -  《-》

Incidence and Risk Factors for Cannula-Related Venous Thrombosis After Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Failure.

Fisser C ，Reichenbächer C ，Müller T ，Schneckenpointner R ，Malfertheiner MV ，Philipp A ，Foltan M ，Lunz D ，Zeman F ，Lubnow M ... -  《-》