Clinical and Applied Thrombosis/Hemostasis (Oct 2023)

Prevalence and Impact of Lupus Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation

  • Andrea Kornfehl MD,
  • Roman Brock MD,
  • Thomas Staudinger MD,
  • Peter Schellongowski MD,
  • Bernhard Nagler MD,
  • Alexander Hermann MD, PhD,
  • Oliver Robak MD,
  • Michael Schwameis MD,
  • Peter Quehenberger MD,
  • Nina Buchtele MD, PhD

DOI
https://doi.org/10.1177/10760296231207062
Journal volume & issue
Vol. 29

Abstract

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Background Monitoring of blood coagulation is essential in ECMO patients. We investigated the prevalence of lupus anticoagulant (LA) and its association with coagulation testing and hemostaseologic complications in patients treated with ECMO. Methods This is a retrospective analysis including adult patients who received ECMO at a medical intensive care unit at the Medical University of Vienna. The primary outcome was the prevalence of LA. Secondary outcomes included conditions associated with LA positivity, rates of bleeding and thromboembolic events, as well as the proportions of aPTT and antiXa measurements within the target range. Results Between 2013 and 2021 193 patients received ECMO, in 62 (32%) of whom LA diagnostics were performed. Twenty-two (35%) patients tested positive. LA positive patients had more frequently received VV ECMO (77.3% vs 34.3%; p = 0.002), were more frequently diagnosed with viral respiratory infections (SARS-CoV2: 45.5% vs 20%; p = 0.041, influenza virus: 22.7% vs 0%; p = 0.003), had a longer ECMO treatment duration (25 vs 10 days; p = 0.011) and a longer ICU stay (48 vs 25 days; p = 0.022), but similar rates of bleeding and thromboembolic events.