VPB0127 - DYNAMICS OF HEMOSTASIS SYSTEM’S PARAMETERS IN PATIENTS WITH SEVERE COURSE OF COVID-19 UNDERGOING EXTRACORPOREAL MEMBRANE OXYGENATION

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Elena Klychnikova, MD

Head of the Scientific clinical and biochemical laboratory
doctor
Moscow, Moskva, Russia

Co-Author(s)

II

Ivan Ivanov

doctor
N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
Moscow, Moskva, Russia
ET

Elizaveta Tazina

Senior Researcher
N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
Moscow, Moskva, Russia
SZ

Sergey Zhuravel

Head of the anesthesiology
N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
Moscow, Moskva, Russia
KP

Konstantin Popugaev

Deputy Director
N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
Moscow, Moskva, Russia
SP

Sergey Petrikov

Head of the Research Institute for Emergency Medicine
N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
Moscow, Moskva, Russia

Background: Extracorporeal membrane oxygenation’s (ECMO) support causes various hemostatic disorders that are poorly understood, especially in COVID-19 patients with severe acute respiratory distress syndrome (ARDS)

Aims: To assess changes in hemostasis parameters during and without ECMO support in COVID-19 patients with severe ARDS

Methods: A prospective study of 122 patients with a severe course of COVID-19 was carried out. The average age was 59±12 years. The patients’ condition, assessed by the NEWS and SOFA severity score, was 4.5±1.4 and 6.1±1.3 points, respectively. Retro-prospective study of 130 patients with a severe course of COVID-19 requiring the use of ECMO was carried out. The average age of patients was 55±6 years. The patients’ condition, assessed by the RESP and SOFA severity score, was 1± 2 and 10 ±2 points respectively. Median ECMO duration was 8 [IQR 4-14] days and median time from intubation to ECMO start was 1 [IQR 1-3] day. All patients were examined for PT, FG, Pr C, AT III, D-dimer and platelet count. The research was performed on day 1 and 7 after ECMO application. Statistical analysis was carried out using Statistica 10.0 software.

Results: On day 1 patients with ECMO showed a significant decrease in the level of FG, PT, platelet count and the activity of AT III (p < 0.05) and an increase in the level of D-dimer (p < 0.05). On day 7 there was also a decrease in the level of FG and PT, the activity of AT III, Pr C and an increase in the level of D-dimer.

Conclusion(s): ECMO triggers early activation of coagulation, which leads to the consumption of FG, PT and platelets, followed by hypofibrinogenemia and thrombocytopenia that may possibly contribute to the high rate of hemorrhagic complications. On the other hand, a decrease in the activity of AT III and Pr C may contribute to thrombotic complications.