Outcome of patients with COVID-19 supported by veno-venous extracorporeal membrane oxygenation with major bleeding: a single centre experience.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

BMC Anesthesiology Pub Date : 2025-10-02 DOI:10.1186/s12871-025-03380-9

Simon Dubler, Michael Kowarik, Bettina Budeus, Tomas Habanik, Denise Zwanziger, Annabell Skarabis, Florian Espeter, Thorsten Brenner, Frank Herbstreit

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引用次数: 0

Abstract

Background: Patients with severe COVID-19 often require veno-venous extracorporeal membrane oxygenation (VV-ECMO) due to acute respiratory distress syndrome (ARDS). Major bleeding complications are common and linked to worse outcomes, though specific risk factors in COVID-19 remain unclear.

Methods: A retrospective analysis of 151 critically ill patients with COVID-19 on VV-ECMO (March 2020-December 2021) was conducted. The primary outcome was major bleeding (fatal bleeding, haemoglobin drop ≥ 20 g/L^-1 (1.24 mmol/L^-1), or symptomatic bleeding in critical organs). Secondary outcomes included 90-day mortality, kidney replacement therapy, and disease severity.

Results: Major bleeding occurred in 73/151 patients (48.3%). Only a longer ECMO duration [OR 1.32 (95% CI 1.14-1.53; p < 0.001)] was identified as an independent risk factor. Kidney replacement therapy independently influenced 90-day mortality [OR 4.48 (95% CI 1.83-10.98;p = 0.001). However, major bleeding, intracranial haemorrhage, higher burden of co-morbidity and mean aPTT before major bleeding were not associated with an increased 90-day mortality risk.

Conclusion: Major bleeding events, including intracranial haemorrhage, are common in patients with COVID-19 being supported by VV-ECMO. However, our data does not demonstrate a direct association between major bleeding and increased 90-day mortality.

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经静脉-静脉体外膜氧合支持并大出血的COVID-19患者的结局：单中心经验

背景：重症COVID-19患者通常因急性呼吸窘迫综合征（ARDS）需要静脉-静脉体外膜氧合（VV-ECMO）。大出血并发症很常见，与更糟糕的结果有关，尽管COVID-19的具体风险因素尚不清楚。方法：对151例危重患者（2020年3月- 2021年12月）进行VV-ECMO回顾性分析。主要结局为大出血（致死性出血、血红蛋白下降≥20 g/L-1 （1.24 mmol/L-1）或关键器官症状性出血）。次要结局包括90天死亡率、肾脏替代治疗和疾病严重程度。结果：151例患者中有73例（48.3%）发生大出血。只有更长的ECMO持续时间[OR 1.32 (95% CI 1.14-1.53； p]结论：在VV-ECMO支持的COVID-19患者中，包括颅内出血在内的大出血事件很常见。然而，我们的数据并未显示大出血与90天死亡率增加之间存在直接关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Anesthesiology ANESTHESIOLOGY-

CiteScore

3.50

自引率

4.50%

发文量

349

审稿时长

>12 weeks

期刊介绍： BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.