ArticleIntensive care medicine2022
Bleeding and thrombotic events in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study.
Article in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Assessing Venous Thrombotic Risks in Extracorporeal Membrane Oxygenation-Supported Patients: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Gastrointestinal bleeding in patients on venoarterial extracorporeal membrane oxygenation: a multicenter observational study.BMC gastroenterology · 2026Observational
- Stroke Subtype as a Determinant of Mortality in Adult Patients on Extracorporeal Membrane Oxygenation.Journal of clinical medicine · 2026Article
- Refining an acute respiratory distress syndrome animal model supported by extracorporeal membrane oxygenator: incorporating clinically relevant mechanical ventilation strategy upon development.Intensive care medicine experimental · 2026Article
- Daily biomarker trajectories predict major bleeding in patients on venovenous ECMO for ARDS: a retrospective longitudinal cohort study.Scientific reports · 2026Article
- Mortality and complications in low-dose vs standard-dose unfractionated heparin anticoagulation for extracorporeal membrane oxygenation: a systematic review and meta-analysis.Research and practice in thrombosis and haemostasis · 2026Article
- Gut-Brain Axis Dysregulation in Inflammatory Bowel Disease: Implications for Coagulation Abnormalities and Extraintestinal Manifestations.International journal of general medicine · 2026Review
- Outcome of patients with COVID-19 supported by veno-venous extracorporeal membrane oxygenation with major bleeding: a single centre experience.BMC anesthesiology · 2025Article
- Incidence, kinetics, and clinical impact of thrombocytopenia in venovenous ECMO: insights from the multicenter observational PROTECMO study.Critical care (London, England) · 2025Observational
- Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model.Intensive care medicine experimental · 2025Article
- Analysis of the feasibility of a low-anticoagulation strategy in patients undergoing post-cardiotomy extracorporeal membrane oxygenation: a retrospective cohort study.BMC anesthesiology · 2025Article
- Characteristics of Bleeding Complications in Patients with Severe COVID-19 Requiring Veno-venous Extracorporeal Membrane Oxygenation in Japan.Thrombosis and haemostasis · 2025Observational
- Impact of bleeding and thrombosis on outcome of 945 COVID-19 VV-ECMO cases from a German registry.Frontiers in medicine · 2025Article
- Lessons Learned From Awake ECMO Approach in Covid-19-Related Acute Respiratory Distress Syndrome - a Scoping Review.Therapeutics and clinical risk management · 2025Review
- Anticoagulation in venovenous extracorporeal membrane oxygenation.Frontiers in medicine · 2025Review
- In COVID-19 Patients Supported with Extracorporeal Membrane Oxygenation, Intensive Care Unit Mortality Is Associated with the Blood Transfusion Rate.Journal of clinical medicine · 2024Article
- Anticoagulation and associated complications in veno-arterial extracorporeal membrane oxygenation in adult patients: A systematic review and meta-analysis.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Review
- Between a rock and a hard place: anticoagulation management for ECMO.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Pulmonary perfusion in long-term survivors of COVID-19-related severe acute respiratory distress syndrome treated by extracorporeal membrane oxygenation.Pulmonary circulation · 2024Article
- Anticoagulation during extracorporeal membrane oxygenation.The Cochrane database of systematic reviews · 2024Article
Corrections and comments
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Authors and funding
16 authors at 8 institutions in 2 countries.
Funding
Abstract
purposeTo describe bleeding and thrombotic events and their risk factors in patients receiving extracorporeal membrane oxygenation (ECMO) for severe coronavirus disease 2019 (COVID-19) and to evaluate their impact on in-hospital mortality.
methodsThe ECMOSARS registry included COVID-19 patients supported by ECMO in France. We analyzed all patients included up to March 31, 2022 without missing data regarding bleeding and thrombotic events. The association of bleeding and thrombotic events with in-hospital mortality and pre-ECMO variables was assessed using multivariable logistic regression models.
resultsAmong 620 patients supported by ECMO, 29% had only bleeding events, 16% only thrombotic events and 20% both bleeding and thrombosis. Cannulation site (18% of patients), ear nose and throat (12%), pulmonary bleeding (9%) and intracranial hemorrhage (8%) were the most frequent bleeding types. Device-related thrombosis and pulmonary embolism/thrombosis accounted for most of thrombotic events. In-hospital mortality was 55.7%. Bleeding events were associated with in-hospital mortality (adjusted odds ratio (adjOR) = 2.91[1.94-4.4]) but not thrombotic events (adjOR = 1.02[0.68-1.53]). Intracranial hemorrhage was strongly associated with in-hospital mortality (adjOR = 13.5[4.4-41.5]). Ventilation duration before ECMO ≥ 7 days and length of ECMO support were associated with bleeding. Thrombosis-associated factors were fibrinogen ≥ 6 g/L and length of ECMO support.
conclusionsIn a nationwide cohort of COVID-19 patients supported by ECMO, bleeding incidence was high and associated with mortality. Intracranial hemorrhage incidence was higher than reported for non-COVID patients and carried the highest risk of death. Thrombotic events were less frequent and not associated with mortality. Length of ECMO support was associated with a higher risk of both bleeding and thrombosis, supporting the development of strategies to minimize ECMO duration.
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