Keywords
Extracorporeal Life Support
Blood clotting disorders
Thromboembolism
How to Cite
Abstract
Extracorporeal membrane oxygenation (ECMO) is considered an important rescue therapy in cases involving refractory pulmonary insufficiency induced by coronavirus disease 2019. However, major disorders largely related to episodes of circuit thrombosis have been reported. The present study evaluated how pathophysiological mechanisms of COVID-19 associated with blood clotting disorders interfere in the prognosis of patients treated with ECMO. To assess the project feasibility, individual searches in PubMed, Embase, Web of Science and CINAHL databases were performed using DeCS/MeSH descriptors and Boolean operators from February 1, 2021 to May 6, 2022. It has been found that hypercoagulable state is one of the most important etiologies for ECMO failure in patients with COVID-19 infection who have developed severe Acute Respiratory Distress Syndrome (ARDS) and that elevated D-dimer levels at initial presentation, inflammatory markers and altered coagulation parameters act as important predictors of complications. The study concludes that thromboembolic disorders have a higher incidence in COVID-19 patients treated with extracorporeal life support due to complications of Sars-CoV-2 infection, but do not affect the mortality rate associated with this therapy. Further research is needed to define thromboprophylaxis optimal dose and course in patients with COVID-19, in order to improve anticoagulation monitoring during extracorporeal life support.
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