Department of Medicine I - Intensive Care Unit 13i2, Medical University of Vienna, Vienna, Austria.
Section for Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
ASAIO J. 2022 Nov 1;68(11):1407-1413. doi: 10.1097/MAT.0000000000001675. Epub 2022 Feb 15.
Extracorporeal carbon dioxide removal (ECCO 2 R) has gained widespread use as a supposedly less invasive alternative for hypercapnic respiratory failure besides venovenous extracorporeal membrane oxygenation (VV ECMO). Despite technological advances, coagulation-related adverse events remain a major challenge in both therapies. The overlapping operating areas of VV ECMO and pump-driven ECCO 2 R could allow for a device selection targeted at the lowest risk of such complications. This retrospective analysis of 47 consecutive patients compared hemostatic changes between pump-driven ECCO 2 R (n = 23) and VV ECMO (n = 24) by application of linear mixed effect models. A significant decrease in platelet count, increase in D-dimer levels, and decrease of fibrinogen levels were observed. However, except for fibrinogen, the type of extracorporeal support did not have a significant effect on the time course of these parameters. Our findings suggest that in terms of hemocompatibility, pump-driven ECCO 2 R is not significantly different from VV ECMO.
体外二氧化碳去除（ECCO2R）作为一种替代高碳酸血症性呼吸衰竭的方法，除了静脉-静脉体外膜氧合（VV ECMO）之外，因其侵袭性较小而得到广泛应用。尽管技术不断进步，但与凝血相关的不良事件仍然是这两种治疗方法的主要挑战。VV ECMO 和泵驱动的 ECCO2R 的重叠操作区域可以选择设备，以将此类并发症的风险降到最低。本研究对 47 例连续患者进行回顾性分析，通过线性混合效应模型比较了泵驱动的 ECCO2R（n=23）和 VV ECMO（n=24）之间的止血变化。观察到血小板计数减少、D-二聚体水平升高和纤维蛋白原水平降低。然而，除了纤维蛋白原，体外支持的类型对这些参数的时间过程没有显著影响。我们的研究结果表明，在血液相容性方面，泵驱动的 ECCO2R 与 VV ECMO 没有显著差异。
