To study the differences in hemorrhagic and embolic complications between extracorporeal cardiopulmonary resuscitation (ECPR) patients who received and did not receive a loading dose of heparin.
This study is a controlled before-after monocentric retrospective study.
Based on whether they received a loading dose of heparin anticoagulation therapy before catheterization, they were divided into a loading dose group and a non-loading dose group, respectively.
We studied a total of 28 patients who, following a cardiac arrest, underwent ECPR in the emergency department of the Aerospace Center Hospital (ASCH) from January 2018 to May 2022.
We compared the hemorrhagic and embolic complications and prognosis of the two groups.
Measurements & Main Results
There were 12 cases in the loading dose group and 16 cases in the non-loading dose group. There was no statistically significant difference in age, gender, underlying diseases, causes of cardiac arrest, and hypoperfusion time between the two groups. The incidence of hemorrhagic complications was 75% in the loading dose group and 67.5% in the non-loading dose group. The difference between the two groups was not statistically significant (P > 0.05). The incidence of life-threatening massive hemorrhage in the loading dose group was 50%, and that in the non-loading dose group was 12.5%. The difference between the two groups was statistically significant (P = 0.03). The incidence of embolic complications in the loading dose group and non-loading dose group was 8.3% and 12.5%, respectively, and the difference between the two groups was not statistically significant (P > 0.05). The survival rates of the two groups were 8.3% vs 18.8%, respectively, and the difference between the two groups was not statistically significant (P > 0.05).
In conclusion, in our study of patients undergoing ECPR, the administration of a loading dose of heparin was associated with an increased risk of early fatal hemorrhage. While stopping this loading dose did not raise the risk of embolic complications. It did not lower the risk of total hemorrhage and transfusion.
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