Evidence map›Paper›PMID 38739366›Full record

ReviewPerfusion2025

Evaluation of an aPTT guided versus a multimodal heparin monitoring approach in patients on extra corporeal membrane oxygenation: A retrospective cohort study.

Diman Taha, Joppe G Drop, Enno D Wildschut, Matthijs De Hoog, C Heleen van Ommen, Dinis Dos Reis Miranda

Abstract readReview
In one paragraph

Review in Perfusion, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

6 authors.

Diman TahaDepartment of Adult Intensive Care, Erasmus Medical Center, Rotterdam, the Netherlands.ORCID 0009-0005-8622-7699
Joppe G DropDepartment of Pediatric Hematology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.ORCID 0000-0001-6898-1595
Enno D WildschutDepartment of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
Matthijs De HoogDepartment of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
C Heleen van OmmenDepartment of Pediatric Hematology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
Dinis Dos Reis MirandaDepartment of Adult Intensive Care, Erasmus Medical Center, Rotterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

IntroductionBleeding and thrombotic complications are common in extracorporeal membrane oxygenation (ECMO) patients and are associated with increased mortality and morbidity. The optimal anticoagulation monitoring protocol in these patients is unknown. This study aims to compare the incidence of thrombotic and hemorrhagic complications before and after a protocol change. In addition, the association between hemostatic complications, coagulation tests and risk factors is evaluated.MethodsThis is a retrospective single center cohort study of adult ECMO patients. We collected demographics, ECMO parameters and coagulation test results. Outcomes of the aPTT guided and multimodal protocol, including aPTT, anti-Xa assay and rotational thromboelastometry were compared and the association between coagulation tests, risk factors and hemostatic complications was determined using a logistic regression analysis for repeated measurements.ResultsIn total, 250 patients were included, 138 in the aPTT protocol and 112 in the multimodal protocol. The incidence of thrombosis (aPTT: 14%; multimodal: 12%) and bleeding (aPTT: 36%; multimodal: 40%), did not significantly differ between protocols. In the aPTT guided protocol, the aPTT was associated with thrombosis (Odds Ratio [OR] 1.015; 95% confidence interval [CI] 1.004-1.027). In both protocols, surgical interventions were risk factors for bleeding and thrombotic complications (aPTT: OR 93.2, CI 39.9-217.6; multimodal OR 17.5, CI 6.5-46.9).DiscussionThe incidence of hemostatic complications was similar between both protocols and surgical interventions were a risk factor for hemostatic complications. Results from this study help to elucidate the role of coagulation tests and risk factors in predicting hemostatic complications in patients undergoing ECMO support.

Indexed as

AnticoagulantsExtracorporeal Membrane OxygenationHeparinThrombosisAdultAgedCohort StudiesFemaleHemorrhageHumansMaleMiddle AgedPartial Thromboplastin TimeRetrospective StudiesRisk FactorsAnticoagulantsHeparinblood coagulation testextracorporeal membrane oxygenationhemorrhagepartial thromboplastin timethrombosis

Identifiers

PMID38739366
PMCPMC11951356

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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.