Abstract Number: PB0289
Meeting: ISTH 2020 Congress
Background: Bleeding and thrombotic events are the most common complications associated with veno-venous Extracorporeal Membrane Oxygenation (vv-ECMO) support. In patients with vv-ECMO, changes in the hemostatic balance including consumption of clotting factors, acquired von Willebrand defect, platelet dysfunction and altered fibrinolysis may result in both bleeding and thrombotic events, but their onset are difficult to predict. Data on the use of coagulation point-of-care tests in patients with vv-ECMO are scarce.
Aims: To compare the Quantra Point-of-Care Hemostasis Analyzer with laboratory parameters.
Methods: We conducted a prospective monocentric study at the Intensive Care Unit (ICU) of the Pitié-Salpêtrière Hospital. All adult patients admitted to ICU between November 2019 and January 2020 undergoing vv-ECMO were included in the study. Blood samples from patients were collected at baseline, then at days 1, 3, 5 and 7 after ECMO implantation. Quantra sonorheometric-based measurements included Clot Time (CT), Heparinase Clot Time (CTH), Clot Time Ratio (CTR), Clot Stiffness (CS), Fibrinogen (FCS) and Platelet (PCS) Contributions to clot stiffness. Laboratories parameters included platelet count, Activated Partial Thromboplastin Time (APTT), Prothrombin Time (PT), and Fibrinogen levels.
Results: Six patients were included in the study (n=30 samples). Significant correlations were observed between CT and APTT (r=0.624, p< 0.001), CTH and APTT (r=0.747, p< 0.0001), FCS and fibrinogen levels (r=0.798, p< 0.0001), CS and fibrinogen levels (r=0.818, p< 0.0001), and PCS and platelet count (r=0.849, p< 0.0001). All patients receiving unfractionated heparin had a Patient APPT / control APTT ratio < 1.2 and a CTR < 1.5. A 100% agreement between the Patient APTT / control APTT ratio and the CTR was observed (weighted kappa=1; p< 0.0001). Two patients presented a thrombotic event; CS and PCS dropped prior the onset of the thrombotic event in both patients.
Conclusions: The Quantra CT, FCS and PCS well-reflected APTT, fibrinogen-dependent clot stiffness properties, and platelet count.
To cite this abstract in AMA style:Lejeune M, Masi P, Desnos C, Pinton De Chambrun M, Chommeloux J, Martin-Toutain I, Nguyen G, Nieszkowska A, Bréchot N, Schmidt M, Luyt C-, Lefèvre I, Combes A, Hekimian G, Frere C. Comparison of a New Point-of-Care Hemostasis Analyzer with Laboratory Parameters in Patients with Veno-venous Extracorporeal Membrane Oxygenation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/comparison-of-a-new-point-of-care-hemostasis-analyzer-with-laboratory-parameters-in-patients-with-veno-venous-extracorporeal-membrane-oxygenation/. Accessed October 1, 2023.
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