Incidence of Cannula-Associated Deep Vein Thrombosis after Veno-Venous Extracorporeal Membrane Oxygenation
acute respiratory distress syndrome; cannula associated; deep vein thrombosis; veno-venous ECMO
Limited literature regarding the incidence of cannula-associated deep vein thrombosis (CaDVT) after veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty-eight patients were admitted between August 2014 and January 2016 to the Lung Rescue Unit were included in the study. Protocolized anticoagulation levels (partial thromboplastin time [PTT] 45-55 seconds) and routine post decannulation DVT screening were in place during the study period. Forty-one (85.4%) patients had CaDVT. Of those with CaDVT, 31 (76%) patients were treated with full anti-coagulation therapy. Thirty-four (76%) patients with right internal jugular (RIJ) cannulation had CaDVT at cannula site. Twenty-five (61%) patients had CaDVT in the lower extremity (18 associated right femoral vein cannulation and 7 left femoral vein cannulation). Eighteen (44%) patients had both upper and lower extremity CaDVT. Overall, patients with CaDVT tended to be older, have a higher body mass index (BMI), and on ECMO longer (p = NS). Mean PTT during time on ECMO between patients that did and did not have CaDVT did not differ. No clinical evidence of pulmonary embolism (PE) was seen.
Menaker, J., Tabatabai, A., Rector, R., Dolly, K., Kufera, J., Lee, E., Kon, Z., Sanchez, P., Pham, S., Herr, D., Mazzeffi, M., Rabinowitz, R., O'Connor, J., Stein, D., & Scalea, T. (2017). Incidence of Cannula-Associated Deep Vein Thrombosis after Veno-Venous Extracorporeal Membrane Oxygenation. ASAIO Journal, 63 (5). http://dx.doi.org/10.1097/MAT.0000000000000539