Table 3 Dynamic and standard coagulation parameters in patients during extracorporeal membrane oxygenation therapy divided according to severe or moderate bleeding on day 1 or 2 (n = 42) versus minor or no bleeding day 1 or 2 (n = 58). All data presented as median (interquartile range). Significant values are in bold.

From: Bleeding patients on extracorporeal membrane oxygenation have reduced platelet aggregation and plasma fibrinogen: a longitudinal observational study

 

Bleeding

n = 42

No bleeding

n = 58

p-value

Multiplate*, AUC, all patients (78 healthy controls)

 ADP (870 [740–998] AU*min)

159 (86–336)

367 (170–584)

< 0.001

 ASPI (1069 [961–1178] AU*min)

162 (96–399)

438 (180–605)

< 0.001

 TRAP (1330 [1210–1463] AU*min)

530 (247–813)

698 (465–1046)

0.01

Multiplate*, AUC, Statistical analyses performed without patients with platelet count < 100 × 109/L and treated with platelet inhibitors

 ADP (807 [740–998] AU*min)

216 (143–378)

n = 14

449 (365–656)

n = 31

< 0.001

 ASPI (1069 [961–1178] AU*min)

373 (167–443)

n = 15

576 (452–819)

n = 29

< 0.001

 TRAP (1330 [1210–1463] AU*min)

640 (355–889)

n = 19

803 (541–1099)

n = 29

0.10

ROTEM EXTEM* (reference interval)

 CT (38–79 s)

82 (70–99)

85 (74–97)

0.64

 MAXVEL (2–22 mm/s)

10 (8–13)

16 (10–19)

< 0.001

 t-MAXVEL (48–154 s)

140 (112–171)

124 (104–165)

0.36

 MCF (50–72 mm)

56 (51–62)

63 (57–69)

< 0.001

ROTEM INTEM*

 CT (100–240 s)

225 (202–256)

203 (172–232)

0.02

 MAXVEL (11–25 mm/s)

11 (8–14)

14 (11–19)

< 0.01

 t-MAXVEL (147–223 s)

258 (228–295)

232 (205–268)

0.04

 MCF (50–72 mm)

57 (51–62)

63 (56–67)

< 0.01

ROTEM FIBTEM* MCF (9–25 mm)

12 (8–18)

18 (11–25)

0.047

ROTEM HEPTEM* CT, s

202 (173–237)

191 (172–227)

0.30

ROTEM platelet MCE

112 (91–138)

155 (117–192)

< 0.01

Coagulation and thrombin generation parameters

 Platelet count (145–400 × 109/L)

134 (69–174)

152 (104–210)

0.04

 INR (< 1.2)

1.5 (1.3–1.7)

1.4 (1.2–2.1

0.59

 Antithrombin (80–120%)

60 (48–78)

70 (60–82)

0.02

 Fibrinogen (187–408 mg/dL)

221 (160–340)

306 (241–449)

< 0.01

 APTT (20–29 s)

50 (33–68)

40 (33–50)

0.07

 D-dimer (< 0.80 mg/L FEU)

10.7 (4.3–19)

7.2 (3.1–17.1)

0.25

 TAT (≤ 13 µg/L)

19.7 (9.9–53.2)

15.8 (9.5–32.9)

0.34

Transfusion, day 1, mL

 Red blood cells

600 (282–1536)

0 (0–300)

< 0.0001

 Fresh frozen plasma

0 (0–900)

0 (0–0)

< 0.01

 Platelet concentrate

0 (0–440)

0 (0–0)

< 0.001

  1. *ROTEM® and Multiplate analysis was performed in 36 bleeding and 51 non-bleeding patients.
  2. AUC area under the curve, ADP adenosine diphosphate, ASPI arachidonic acid induced aggregation, TRAP thrombin-receptor-agonist-peptide-6, CT clotting time, MCF maximum clot firmness, MAXVEL maximum velocity, t-MAXVEL time to MAXVEL, MCE maximum clot elasticity, INR international normalized ratio, APTT activated partial thrombin time, TAT thrombin–antithrombin complex.
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