Comparison of the effects of phosphorylcholin versus heparin-based surface coating on clinical and histologic outcomes during veno-arterial extracorporeal membrane oxygenation support: a propensity score weighted analysis

被引：2

作者：

Moussa, Mouhamed Djahoum ^{[1
,2
]}

Abou-Arab, Osama ^{[3
,4
]}

Staessens, Senna ^{[5
,6
]}

Jungling, Marie ^{[2
]}

Labreuche, Julien ^{[8
]}

Lamer, Antoine ^{[2
]}

Beyls, Christophe ^{[3
,4
]}

Rousse, Natacha ^{[7
]}

Rauch, Antoine ^{[5
,9
]}

Loobuyck, Valentin ^{[7
]}

Beaudeux, Camille ^{[2
]}

Pierache, Adeline ^{[8
]}

Deblauwe, Delphine ^{[1
]}

Corseaux, Delphine ^{[5
]}

Dubernet, Martin ^{[1
]}

Guilbart, Mathieu ^{[3
,4
]}

Thellier, Lise ^{[1
,2
]}

Mahjoub, Yazine ^{[3
,4
]}

Juthier, Francis ^{[2
,7
]}

Dupont, Herve ^{[3
,4
]}

Meyer, Simon F. De ^{[6
]}

Vincentelli, Andre ^{[5
,7
]}

Susen, Sophie ^{[5
,9
]}

Robin, Emmanuel ^{[1
,5
]}

机构：

[1] CHU Lille, Dept Anesthesiol & Crit Care, 2 Ave Oscar Lambret, F-59000 Lille, France

[2] Univ Lille, ULR 2694 METRICS Evaluat Technol Sante & Pratiques, CHU Lille, F-59000 Lille, France

[3] Amiens Univ Hosp, Dept Anesthesiol & Crit Care Med, Amiens, France

[4] Jules Verne Univ Picardie, CURS, EA7517, MP3CV, Amiens, France

[5] Univ Lille, Inst Pasteur Lille, Inserm U1011 EGID, CHU Lille, F-59000 Lille, France

[6] Katholieke Univ Leuven, Lab Thrombosis Res, Campus Kulak Kortrijk, Kortrijk, Belgium

[7] CHU Lille, Dept Cardiac Surg, F-59000 Lille, France

[8] CHU Lille, Dept Biostat, F-59000 Lille, France

[9] CHU Lille, Ctr Biol Pathol Genet, Pole Hematol Transfus, F-59000 Lille, France

来源：

JOURNAL OF THROMBOSIS AND HAEMOSTASIS | 2025年 / 23卷 / 06期

关键词：

bleeding; ECMO; heparin; histology; mortality; phosphorylcholin; surface coatings; thrombosis; CARDIOPULMONARY BYPASS CIRCUITS; REDUCED COMPLEMENT; COATED CIRCUITS; ACTIVATION; THROMBOSIS; BIOCOMPATIBILITY; PRESERVATION; TRANSFUSION; IMPROVE; IMPACT;

D O I：

10.1016/j.jtha.2025.02.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is associated with a high rate of thrombotic complications, which are prevented using systemic anticoagulation and surface coating technologies. Heparin and phosphorylcholin (PPC) coatings are widely used in clinical practice, but little is known about their effectiveness in VA-ECMO setting. Objectives: To compare the effects of heparin and PPC coatings on thrombotic complications, bleeding, blood trauma, inflammation, thrombi composition, and mortality. Methods: A retrospective multicenter clinical cohort was studied for clinical endpoints, and a prospective histologic cohort was investigated for thrombi composition. The clinical cohort included adult patients supported by VA-ECMO for cardiogenic shock, without any constitutive or acquired hemostasis disease disorder, from January 2013 to December 2020. Thrombi retrieved from circuit junctions underwent histochemical and immunochemical analysis for erythrocytes, von Willebrand factor (VWF), platelets, fibrinogen, and neutrophil extracellular traps content. The clinical cohort was compared using a propensity score overlap weighting. A P value <.05 was significant. Results: Compared with PPC coating, heparin coating was associated with a lower incidence of thrombotic complications before and after propensity score overlap weighting (hazard ratio [HR]: 0.67; 95% CI: 0.48-0.93; P = .015), a lower decrease in hemoglobin, but a greater decrease in platelet count. In the histologic analysis, PPC coating resulted in a greater content of VWF. The other endpoints were similar among groups. Conclusion: Compared with PPC coating, heparin coating is associated with fewer thrombotic complications during VA-ECMO support. Kinetics of platelet count and hemoglobin, thrombi contents differed according to coating types.

引用

页码：1879 / 1892

页数：14

共 47 条

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