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Severe Thrombocytopenia in Adults with Severe Acute Respiratory Distress Syndrome: Impact of Extracorporeal Membrane Oxygenation Use.
Dzierba, Amy L; Roberts, Russel; Muir, Justin; Alhammad, Abdullah; Schumaker, Greg; Clark, Jacqueline; Ruthazer, Robin; Devlin, John W.
Afiliación
  • Dzierba AL; From the *Department of Pharmacy, NewYork-Presbyterian Hospital, New York, New York; †School of Pharmacy, Northeastern University, Boston, Massachusetts; ‡Department of Pharmacy Services, Massachusetts General Hospital, Boston, Massachusetts; §College of Pharmacy, King Saud University, Riyahd, Saudi Arabia; ¶Division of Pulmonary, Critical Care Medicine and Sleep Medicine, Tufts Medical Center, Boston, Massachusetts; ‖Department of Pharmacy Services, University of Maryland Medical Center, Baltim
ASAIO J ; 62(6): 710-714, 2016.
Article en En | MEDLINE | ID: mdl-27442855
Extracorporeal membrane oxygenation (ECMO) use is perceived to cause thrombocytopenia (T), but the role of non-ECMO factors in the development of T remains unclear. We sought to evaluate the incidence and factors associated with severe T (platelet count ≤ 50,000/µl) in adults with severe acute respiratory distress syndrome (ARDS) managed with or without ECMO. The ECMO (n = 32) versus the non-ECMO (n = 53) groups had a similar baseline platelet count (214,000 vs. 179,000/µl), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p = 0.13), unfractionated heparin (UFH) exposure (p = 0.62), and severe T incidence (25 vs. 19%, p = 0.5). Although the APACHE II score (p = 0.01), presence of liver failure (p = 0.08), and platelet transfusion (p = 0.0009) were different between the severe T (18/85 [21%]) and non-severe T groups (67/85 [79%]), the incidence of septic shock (p = 0.64), heparin infusion use (p = 0.41), exposure to non-heparin T-causing medications (p = 0.77) and ECMO use (p = 0.5) were not. An adjusted multivariate linear regression model revealed that only the APACHE II score was independently associated with the development of severe T (p = 0.01) but use of ECMO was not (p = 0.32) ECMO use may not affect the incidence of severe T among adults with severe ARDS. Larger studies that are prospective in nature are required to confirm this finding.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Trombocitopenia / Oxigenación por Membrana Extracorpórea Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos
Buscar en Google
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Trombocitopenia / Oxigenación por Membrana Extracorpórea Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos