Evidence map›Paper›PMID 38711092›Full record

ArticleJournal of intensive care2024

Hemorrhage and thrombosis in COVID-19-patients supported with extracorporeal membrane oxygenation: an international study based on the COVID-19 critical care consortium.

Maximilian Feth, Natasha Weaver, Robert B Fanning, Sung-Min Cho, Matthew J Griffee, Mauro Panigada, Akram M Zaaqoq, Ahmed Labib, Glenn J R Whitman, Rakesh C Arora and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Evaluating factors associated with the use of extracorporeal membrane oxygenation in major trauma - an analysis of the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Maximilian FethDepartment of Anesthesiology, Intensive Care Medicine, Emergency Medicine, and Pain Medicine, German Armed Forces Hospital Ulm, Ulm, Germany.
Natasha WeaverQueensland University of Technology, Brisbane, QLD, Australia.
Robert B FanningSt. Vincent's Hospital, Melbourne, VIC, Australia.
Sung-Min ChoDivision of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Matthew J GriffeeDepartment of Anesthesiology and Perioperative Medicine, Sections of Critical Care and Perioperative Echocardiography, University of Utah, Salt Lake City, UT, USA.
Mauro PanigadaDepartment of Anesthesia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Di Milano, Intensive Care and Emergency, Milano, Lombardia, Italy.
Akram M ZaaqoqDepartment of Anaesthesiology, Division of Critical Care Medicine, University of Virginia, Charlottesville, VA, USA.
Ahmed LabibMedical Intensive Care Unit, Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Glenn J R WhitmanDivision of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Rakesh C AroraHarrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Bo S KimDivision of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Nicole WhiteQueensland University of Technology, Brisbane, QLD, Australia.
Jacky Y SuenCritical Care Research Group, Level 3, Clinical Sciences Building, The Prince Charles Hospital, ChermsideBrisbane, QLD, 4032, Australia.
Gianluigi Li BassiCritical Care Research Group, Level 3, Clinical Sciences Building, The Prince Charles Hospital, ChermsideBrisbane, QLD, 4032, Australia.
Giles J PeekCongenital Heart Centre, University of Florida, Gainesville, FL, USA.
Roberto LorussoCardiothoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, and Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Heidi DaltonHeart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA, USA.
John F FraserCritical Care Research Group, Level 3, Clinical Sciences Building, The Prince Charles Hospital, ChermsideBrisbane, QLD, 4032, Australia.
Jonathon P FanningCritical Care Research Group, Level 3, Clinical Sciences Building, The Prince Charles Hospital, ChermsideBrisbane, QLD, 4032, Australia. j.fanning@uq.edu.au.ORCID http://orcid.org/0000-0002-1675-0522
COVID-19 Critical Care Consortium

Funding

CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) studyK23HL157610 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Sung-Min Cho · 2022 to 2026
$797k
Gates Foundation INV-034765NHLBI NIH HHS K23 HL157610
6 · The paper itself

Abstract

backgroundExtracorporeal membrane oxygenation (ECMO) is a rescue therapy in patients with severe acute respiratory distress syndrome (ARDS) secondary to COVID-19. While bleeding and thrombosis complicate ECMO, these events may also occur secondary to COVID-19. Data regarding bleeding and thrombotic events in COVID-19 patients on ECMO are sparse.

methodsUsing the COVID-19 Critical Care Consortium database, we conducted a retrospective analysis on adult patients with severe COVID-19 requiring ECMO, including centers globally from 01/2020 to 06/2022, to determine the risk of ICU mortality associated with the occurrence of bleeding and clotting disorders.

resultsAmong 1,248 COVID-19 patients receiving ECMO support in the registry, coagulation complications were reported in 469 cases (38%), among whom 252 (54%) experienced hemorrhagic complications, 165 (35%) thrombotic complications, and 52 (11%) both. The hazard ratio (HR) for Intensive Care Unit mortality was higher in those with hemorrhagic-only complications than those with neither complication (adjusted HR = 1.60, 95% CI 1.28-1.99, p < 0.001). Death was reported in 617 of the 1248 (49.4%) with multiorgan failure (n = 257 of 617 [42%]), followed by respiratory failure (n = 130 of 617 [21%]) and septic shock [n = 55 of 617 (8.9%)] the leading causes.

conclusionsCoagulation disorders are frequent in COVID-19 ARDS patients receiving ECMO. Bleeding events contribute substantially to mortality in this cohort. However, this risk may be lower than previously reported in single-nation studies or early case reports. Trial registration ACTRN12620000421932 ( https://covid19.cochrane.org/studies/crs-13513201 ).

Indexed as

Bleeding eventsCoagulation disordersCOVID-19Extracorporeal membrane oxygenationThrombotic events

Identifiers

PMID38711092
PMCPMC11071263

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.