Journal: Asaio Journal

Article Title: Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia

doi: 10.1097/MAT.0000000000002383

Figure Lengend Snippet: Flowchart of the study patients. Patients with incomplete datasets of platelet counts after ECMO start, ECMO time ≤1 day, and short run times of the first ECMO system (≤7 days) were excluded. The “long-first-run group” included patients with long (≥8 days) and exchange-free first runs. *Run times were defined as the time of the first system until the exchange or end of therapy. The long-first-run group was subdivided into patients with only one ECMO system (excluded) and with more than one system (n = 145). The “long-second-run group” included all patients that required a second ECMO system with long (≥7 days) and exchange-free runs (time from the day of exchange to the end of therapy or exchange of the second system). Both study groups regarded the underlying disease (bacterial, viral, and COVID-19 pneumonia) and different first ECMO systems (Cardiohelp; PLS; HiliteLT7000; ECC.O5 [see Table S1, Supplemental Digital Content, http://links.lww.com/ASAIO/B406 ]; other systems: iLA [Novalung, Heilbronn, Germany], Nautilus oxygenators [Medtronic, Minneapolis, MN], Paragon oxygenators [Chalice Medical, Nottinghamshire, UK], PALP [Maquet]). Data are shown as n (%). COVID-19, coronavirus disease 2019; iLA, interventional lung assist; PALP, pump-assisted lung protection; V-V ECMO, venovenous extracorporeal membrane oxygenation.

Article Snippet: The ECMO systems included Cardiohelp HLS and PLS (Getinge/Maquet, Rastatt, Germany), DP3 system (Fresenius/Xenios, Heilbronn, Germany), Life-Box (SorinGroup/LivaNova, Milan, Italy), and others (Figure , see Table S1, Supplemental Digital Content, http://links.lww.com/ASAIO/B406 ).

Techniques: Membrane

Journal: Asaio Journal

Article Title: Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia

doi: 10.1097/MAT.0000000000002383

Figure Lengend Snippet: Dynamics of platelet counts of patients from the long-first-run group ( A ) and the long-second-run group ( B ) stratified by the underlying disease. A : Time line of platelet count within 8 days after ECMO start. The decline was significant for patients with bacterial (n = 142), viral (n = 76), and COVID-19 (n = 112) pneumonia (each, p < 0.001). Patients with COVID-19 presented the highest platelet counts until day 7 after ECMO start. B : Time line of platelet count within 7 days after ECMO exchange. Although platelet count remained unchanged in the bacterial pneumonia group (n = 31), platelet count increased significantly in the COVID-19 group (n = 48) (within 2 days, p < 0.01) and in the viral pneumonia group (n = 22) (within 4 days, p < 0.05). There were no differences in the platelet count comparing the disease groups. Boxes are median, IQRs, minimum and maximum values. Statistics: two-way ANOVA for time lines compared with data before ECMO or at the exchange day (day 0) (* p < 0.05, ** p < 0.01, *** p < 0.001); one-way ANOVA for comparison at respective time points (a: p < 0.001; b: p < 0.01; c: p < 0.05). ANOVA, analysis of variance; COVID-19, coronavirus disease 2019; ECMO, extracorporeal membrane oxygenation; IQR, interquartile range.

Article Snippet: The ECMO systems included Cardiohelp HLS and PLS (Getinge/Maquet, Rastatt, Germany), DP3 system (Fresenius/Xenios, Heilbronn, Germany), Life-Box (SorinGroup/LivaNova, Milan, Italy), and others (Figure , see Table S1, Supplemental Digital Content, http://links.lww.com/ASAIO/B406 ).

Techniques: Comparison, Membrane

Journal: Asaio Journal

Article Title: Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia

doi: 10.1097/MAT.0000000000002383

Figure Lengend Snippet: Dynamics of D-dimers (A), fibrinogen (B), INR (C), ATIII (D), fHb) (E), LDH) (F), CRP, (G) and blood flow (H) from the long-first-run group stratified by the underlying disease. Time line of respective parameters within 8 days after ECMO start of patients with bacterial, viral, and COVID-19 pneumonia. Increase of D-dimers was significant (each, p < 0.001). Decline of fibrinogen was significant for bacterial and COVID-19 (each, p < 0.001) and viral ( p = 0.002) pneumonia. INR remained unchanged. Increase of ATIII was significant (each, p < 0.001). Decline of fHb was significant for bacterial and viral ( p < 0.001, p = 0.004) but not for COVID-19 pneumonia. fHb from COVID-19 were significantly lower compared with bacterial and viral pneumonia. Decline of LDH was significant only for COVID-19 ( p < 0.001). LDH from viral pneumonia was significantly higher compared with bacterial and COVID-19 pneumonia. Alterations in CRP were significant (each, p < 0.001). Independent of the underlying disease, blood flow was reduced within 4–5 days (each, p < 0.001). Patients with COVID-19 require significantly higher blood flow rates. Boxes are median, IQRs, minimum and maximum values. Statistics: two-way ANOVA for time lines compared with data before ECMO (day 0) (* p < 0.05; ** p < 0.01; *** p < 0.001); one-way ANOVA for comparison at respective time points (a: p < 0.001; b: p < 0.01; c: p < 0.05). ANOVA, analysis of variance; ATIII, antithrombin III; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; ECMO, extracorporeal membrane oxygenation; fHb, free hemoglobin; INR, international normalized ratio; IQR, interquartile range; LDH, lactate dehydrogenase.

Article Snippet: The ECMO systems included Cardiohelp HLS and PLS (Getinge/Maquet, Rastatt, Germany), DP3 system (Fresenius/Xenios, Heilbronn, Germany), Life-Box (SorinGroup/LivaNova, Milan, Italy), and others (Figure , see Table S1, Supplemental Digital Content, http://links.lww.com/ASAIO/B406 ).

Techniques: Comparison, Membrane

Journal: Asaio Journal

Article Title: Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia

doi: 10.1097/MAT.0000000000002383

Figure Lengend Snippet: Dynamics of pump speed, blood flow, (B, E) and platelet count (C, F) of the long-first-run group (n = 330) ( A–C ) and of the long-second-run group (n = 101) ( D–F ) of different ECMO systems. ( A, D ) Pump speed (RPM) was highest for the DP3 of the Hilite system and lowest for the revolution of the ECC.O5 system. A : Pump speed remained unchanged until day 5 after ECMO start and decreased thereafter. D : Pump speed remained unchanged until day 3–6 after the ECMO exchange and decreased thereafter. B : Blood flow remained unchanged until 4–5 days after ECMO start (independent of ECMO type) and ( E ) until 5–7 days after ECMO exchange. C : The decline of platelet counts after ECMO start was independent of ECMO type. F : After the exchange, platelet count significantly increased for the Cardiohelp and Hilite systems ( p < 0.001, p < 0.05) or remained unchanged (PLS and ECC.O5). There were no differences between ECMO systems at individual time points. Boxes are median, IQRs, minimum and maximum values. Statistics: two-way ANOVA for time lines compared with data before ECMO or at the exchange day (day 0) (* p < 0.05; ** p < 0.01; *** p < 0.001); one-way ANOVA for comparison at respective time points (a: p < 0.001; b: p < 0.01; c: p < 0.05). ANOVA, analysis of variance; ECMO, extracorporeal membrane oxygenation; IQR, interquartile range; RPM, rounds per minute.

Article Snippet: The ECMO systems included Cardiohelp HLS and PLS (Getinge/Maquet, Rastatt, Germany), DP3 system (Fresenius/Xenios, Heilbronn, Germany), Life-Box (SorinGroup/LivaNova, Milan, Italy), and others (Figure , see Table S1, Supplemental Digital Content, http://links.lww.com/ASAIO/B406 ).

Techniques: Comparison, Membrane

Journal: PLoS ONE

Article Title: Life span of different extracorporeal membrane systems for severe respiratory failure in the clinical practice

doi: 10.1371/journal.pone.0198392

Figure Lengend Snippet: Total EMCO support time and life span of the first ECMO system.

Article Snippet: Between January 2010 and November 2017, 461 adult patients with severe respiratory failure were treated with conventional ECMO systems [PLS-system (PLS, n = 117), Cardiohelp HLS-set (CH, n = 107), both Maquet Cardiopulmonary, Rastatt, Germany; Deltastream-system/Hilite7000LT (HL, n = 135), iLA-activve (n = 15), Xenios/NovaLung, Heilbronn, Germany; ECC.O5-system (ECC.05, n = 87), LivaNova, Mirandola, Italy] ( ) [ – ].

Techniques: Significance Assay

Journal: PLoS ONE

Article Title: Life span of different extracorporeal membrane systems for severe respiratory failure in the clinical practice

doi: 10.1371/journal.pone.0198392

Figure Lengend Snippet: Exchange criteria from 139 ECMO patients that required a system exchange including data from five different ECMO systems (PLS, CH, HL, ECC.O5, iLA-activve, see and Tables). (A) Proportion (in %) of acute (MF, mechanical failure; AOT, acute oxygenator thrombosis; PHT, pump head thrombosis) (filled bars) and elective (GT, worsened gas transfer; CD, coagulation disorder; bleeding diathesis) exchange reasons (white bars). (B) Median (IQR) of the life span of acute and elective exchanges of the different ECMO systems. P-values compared the life span of acute and elective exchanges. The numbers within the bars represent the number of exchanges.

Article Snippet: Between January 2010 and November 2017, 461 adult patients with severe respiratory failure were treated with conventional ECMO systems [PLS-system (PLS, n = 117), Cardiohelp HLS-set (CH, n = 107), both Maquet Cardiopulmonary, Rastatt, Germany; Deltastream-system/Hilite7000LT (HL, n = 135), iLA-activve (n = 15), Xenios/NovaLung, Heilbronn, Germany; ECC.O5-system (ECC.05, n = 87), LivaNova, Mirandola, Italy] ( ) [ – ].

Techniques: Coagulation