Comparison of bleeding and thrombotic outcomes in veno‐venous extracorporeal membrane oxygenation: Heparin versus bivalirudin

Objectives We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno‐venous extracorporeal membrane oxygenation (V‐V ECMO). Methods We performed a retrospective cohort study of adult patients placed on V‐V ECMO with intravenous anticoagulation with eit...

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Bibliographic Details
Published in:European journal of haematology 2024-04, Vol.112 (4), p.566-576
Main Authors: Kartika, Thomas, Mathews, Rick, Migneco, Gina, Bundy, Taylor, Kaempf, Andy J., Pfeffer, Michael, DeLoughery, Thomas G., Moore, Kerry, Beardshear, Rachel, Oetken, Heath J., Case, Jonathan, Hinds, Monica T., McCarty, Owen J. T., Shatzel, Joseph J., Zonies, David, Zakhary, Bishoy
Format: Article
Language:English
Subjects:
anticoagulation
bivalirudin
Bleeding
COVID-19
Erythrocytes
Extracorporeal membrane oxygenation
Heparin
Life span
Oxygenation
thrombosis
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Summary:Objectives We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno‐venous extracorporeal membrane oxygenation (V‐V ECMO). Methods We performed a retrospective cohort study of adult patients placed on V‐V ECMO with intravenous anticoagulation with either heparin or bivalirudin. Time to thrombotic event and major bleed were analyzed in addition to related outcomes. Results We identified 95 patients placed on V‐V ECMO: 61 receiving heparin, 34 bivalirudin. The bivalirudin group had a higher rate of severe COVID‐19, higher BMI, and longer ECMO duration. Despite this, bivalirudin was associated with reduced risk of thrombotic event (HR 0.14, 95% CI 0.06–0.32, p 
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.14146