Abstract
Objective
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.
Design
This study is a controlled before-after monocentric retrospective study.
Setting
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.
Participants
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.
Interventions
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).
Conclusion
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.
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
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