ECMO (extracorporeal membrane oxygenation) is a life-saving device, used in intensive care to treat severe respiratory or cardiac failure. However, it carries a high risk of serious life-threatening bleeding. Bleeding complications have been attributed to coagulopathy triggered either by the underlying pathology or by the extracorporeal circuit itself, as well as excessive or inappropriate anticoagulation initiated to prevent thrombotic complications. The objective of this cohort is to confirm the interest of the evolution of D-dimers as a prognostic marker of serious bleeding events in patients on veno-venous (VV) or veno-arterial (VA) ECMO, and to determine the threshold.
Study Type
OBSERVATIONAL
Enrollment
100
Collection of an additional of 2.7mL citrate tube of blood for a D-dimer dosage.
Service de Médecine Intensive - Réanimation Nouvel Hôpital Civil
Strasbourg, France
To determine the most discriminating 24-hour D-Dimer increase threshold for predicting a serious bleeding event under ECMO within 24 hours of D-Dimer increase
Difference in D-dimer over 24 hours associated with the occurrence of severe bleeding within 24 hours.
Time frame: 1 month
To estimate the predictive performance of the 24-hour increase in D-dimer in the occurrence of a serious bleeding event on ECMO within 24 hours.
Sensitivity (Se)
Time frame: 1 month
To estimate the predictive performance of the 24-hour increase in D-dimer in the occurrence of a serious bleeding event on ECMO within 24 hours.
Specificity (Spe)
Time frame: 1 month
To estimate the predictive performance of the 24-hour increase in D-dimer in the occurrence of a serious bleeding event on ECMO within 24 hours.
Positive Predictive Value (PPV)
Time frame: 1 month
To estimate the predictive performance of the 24-hour increase in D-dimer in the occurrence of a serious bleeding event on ECMO within 24 hours.
Negative Predictive Value (NPV)
Time frame: 1 month
To estimate the predictive performance of the 24-hour increase in D-dimer in the occurrence of a serious bleeding event on ECMO within 24 hours.
Positive and Negative Likelihood Ratios of 24-Hour D-Dimer Increase
Time frame: 1 month
To estimate the incidence of bleeding and thrombotic complications on ECMO on day 10
Occurrence of hemorrhagic complications on ECMO on day 10: Bleeding events defined by BARC classification, type of bleeding (arterial/venous) and location, transfusions of labile blood products (number/volume/type), other treatments (endoscopy with hemostatic procedure,
Time frame: 1 month
To estimate the incidence of bleeding and thrombotic complications on ECMO on day 10
Occurrence of thrombotic complications on ECMO on day 10: Thrombotic and ischemic events: ischemic stroke, limb/extremity ischemia, acute coronary syndrome, ECMO circuit thrombosis
Time frame: 1 month
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