Utility of D-dimers in COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation
Copyright © ASAIO 2022..
A retrospective study was performed examining the trend of inflammatory markers, including D-dimers, in 29 COVID-19 patients requiring veno-venous (VV) extracorporeal membrane oxygenation (ECMO) support. We observed that COVID-19 patients with pre-cannulation D-dimer levels >3,000 ng/mL had a significantly shorter time from admission to cannulation (4.78 vs . 8.44 days, p = 0.049) compared to those with D-dimer <3,000 ng/mL. Furthermore, patients with D-dimer >3,000 ng/mL had a trend of lower pH (7.24 vs . 7.33), higher pCO 2 (61.33 vs . 50.69), and higher vasoactive inotropic score (7.23 vs . 3.97) at time of cannulation, however, these were not statistically significant. This cohort of patients also required a longer duration of ECMO support (51.44 vs . 31.25 days). However, 13 patients required at least one ECMO-circuit exchange and 16 patients did not require any exchanges. There was a consistent drop in D-dimer values after every circuit exchange, which was not observed in any of the other examined inflammatory markers, including ferritin, lactate dehydrogenase, or C-reactive protein. We propose that elevated D-dimer levels (>3,000 ng/mL) reflect increased disease severity in COVID-19, and predict a longer ECMO course. Once on ECMO, however, the D-Dimer level consistently decreased with every circuit exchange, which may reflect thrombus within the oxygenator rather than just disease severity.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
|---|---|
| Enthalten in: |
ASAIO journal (American Society for Artificial Internal Organs : 1992) - 68(2022), 10 vom: 01. Okt., Seite 1241-1248 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shakoor, Aqsa [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
9007-41-4 |
|---|
| Anmerkungen: |
Date Completed 06.10.2022 Date Revised 03.02.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1097/MAT.0000000000001775 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM34131630X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM34131630X | ||
| 003 | DE-627 | ||
| 005 | 20231226011509.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/MAT.0000000000001775 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1137.xml |
| 035 | |a (DE-627)NLM34131630X | ||
| 035 | |a (NLM)35609187 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shakoor, Aqsa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Utility of D-dimers in COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 06.10.2022 | ||
| 500 | |a Date Revised 03.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © ASAIO 2022. | ||
| 520 | |a A retrospective study was performed examining the trend of inflammatory markers, including D-dimers, in 29 COVID-19 patients requiring veno-venous (VV) extracorporeal membrane oxygenation (ECMO) support. We observed that COVID-19 patients with pre-cannulation D-dimer levels >3,000 ng/mL had a significantly shorter time from admission to cannulation (4.78 vs . 8.44 days, p = 0.049) compared to those with D-dimer <3,000 ng/mL. Furthermore, patients with D-dimer >3,000 ng/mL had a trend of lower pH (7.24 vs . 7.33), higher pCO 2 (61.33 vs . 50.69), and higher vasoactive inotropic score (7.23 vs . 3.97) at time of cannulation, however, these were not statistically significant. This cohort of patients also required a longer duration of ECMO support (51.44 vs . 31.25 days). However, 13 patients required at least one ECMO-circuit exchange and 16 patients did not require any exchanges. There was a consistent drop in D-dimer values after every circuit exchange, which was not observed in any of the other examined inflammatory markers, including ferritin, lactate dehydrogenase, or C-reactive protein. We propose that elevated D-dimer levels (>3,000 ng/mL) reflect increased disease severity in COVID-19, and predict a longer ECMO course. Once on ECMO, however, the D-Dimer level consistently decreased with every circuit exchange, which may reflect thrombus within the oxygenator rather than just disease severity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Fibrin Fibrinogen Degradation Products |2 NLM | |
| 650 | 7 | |a fibrin fragment D |2 NLM | |
| 650 | 7 | |a C-Reactive Protein |2 NLM | |
| 650 | 7 | |a 9007-41-4 |2 NLM | |
| 650 | 7 | |a Ferritins |2 NLM | |
| 650 | 7 | |a 9007-73-2 |2 NLM | |
| 650 | 7 | |a Lactate Dehydrogenases |2 NLM | |
| 650 | 7 | |a EC 1.1.- |2 NLM | |
| 700 | 1 | |a Chen, Stacey |e verfasserin |4 aut | |
| 700 | 1 | |a Hyde, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Brendan |e verfasserin |4 aut | |
| 700 | 1 | |a Toy, Bridget |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Kon, Zachary |e verfasserin |4 aut | |
| 700 | 1 | |a Piper, Greta |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Deane |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t ASAIO journal (American Society for Artificial Internal Organs : 1992) |d 1997 |g 68(2022), 10 vom: 01. Okt., Seite 1241-1248 |w (DE-627)NLM012606766 |x 1538-943X |7 nnns |
| 773 | 1 | 8 | |g volume:68 |g year:2022 |g number:10 |g day:01 |g month:10 |g pages:1241-1248 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/MAT.0000000000001775 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 68 |j 2022 |e 10 |b 01 |c 10 |h 1241-1248 | ||