Platelets, hemostasis, and thromboembolism during treatment of acute respiratory insufficiency with extracorporeal membrane oxygenation.
Twenty-eight patients were supported with long-term extracorporeal membrane oxygenation as a treatment for acute respiratory insufficiency. Clinical, laboratory, and autopsy data concerning platelets, hemostasis, and thromboembolic disease are presented for the periods during and after bypass. During bypass, a "foreign-surface coagulopathy" was encountered which consisted of abnormal bleeding plus frequent, generalized, small and large vessel thromboembolic events. The abnormal bleeding is attributed to heparin, thrombocytopenia, and a qualitative platelet defect. Possible causes of the thromboembolic events including disseminated intravascular coagulation are also discussed, and speculations are offered concerning clinical management and directions for future investigation.
D000293:Adolescent; D000328:Adult; D001792:Blood Platelets; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005734:Gangrene; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D010477:Perfusion; D012131:Respiratory Insufficiency / Q000097:blood / Q000628:therapy*; D013921:Thrombocytopenia / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology*; D013997:Time Factors
D005340:Fibrinogen