Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage Analysis Article Swipe
Ashish Ankola
,
David K. Bailly
,
Ron Reeder
,
Katherine Cashen
,
Heidi J. Dalton
,
Stephen J. Dolgner
,
Myke Federman
,
Rod Ghassemzadeh
,
Adam S. Himebauch
,
Asavari Kamerkar
,
Josh Koch
,
Joseph G. Kohne
,
Margaret Lewen
,
Neeraj Srivastava
,
R.C. Willett
,
Peta Alexander
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2021.812881
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2021.812881
Background: Bleeding is a common complication of extracorporeal membrane oxygenation (ECMO) for pediatric cardiac patients. We aimed to identify anticoagulation practices, cardiac diagnoses, and surgical variables associated with bleeding during pediatric cardiac ECMO by combining two established databases, the Collaborative Pediatric Critical Care Research Network (CPCCRN) Bleeding and Thrombosis in ECMO (BATE) and the Extracorporeal Life Support Organization (ELSO) Registry. Methods: All children (<19 years) with a primary cardiac diagnosis managed on ECMO included in BATE from six centers were analyzed. ELSO Registry criteria for bleeding events included pulmonary or intracranial bleeding, or red blood cell transfusion >80 ml/kg on any ECMO day. Bleeding odds were assessed on ECMO Day 1 and from ECMO Day 2 onwards with multivariable logistic regression. Results: There were 187 children with 114 (61%) bleeding events in the study cohort. Biventricular congenital heart disease (94/187, 50%) and cardiac medical diagnoses (75/187, 40%) were most common, and 48 (26%) patients were cannulated directly from cardiopulmonary bypass (CPB). Bleeding events were not associated with achieving pre-specified therapeutic ranges of activated clotting time (ACT) or platelet levels. In multivariable analysis, elevated INR and fibrinogen were associated with bleeding events (OR 1.1, CI 1.0–1.3, p = 0.02; OR 0.77, CI 0.6–0.9, p = 0.004). Bleeding events were also associated with clinical site (OR 4.8, CI 2.0–11.1, p < 0.001) and central cannulation (OR 1.75, CI 1.0–3.1, p = 0.05) but not with cardiac diagnosis, surgical complexity, or cannulation from CPB. Bleeding odds on ECMO day 1 were increased in patients with central cannulation (OR 2.82, 95% CI 1.15–7.08, p = 0.023) and those cannulated directly from CPB (OR 3.32, 95% CI 1.02–11.61, p = 0.047). Conclusions: Bleeding events in children with cardiac diagnoses supported on ECMO were associated with central cannulation strategy and coagulopathy, but were not modulated by achieving pre-specified therapeutic ranges of monitoring assays.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fcvm.2021.812881
- https://www.frontiersin.org/articles/10.3389/fcvm.2021.812881/pdf
- OA Status
- gold
- Cited By
- 10
- References
- 17
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4206525709
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4206525709Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fcvm.2021.812881Digital Object Identifier
- Title
-
Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage AnalysisWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-01-13Full publication date if available
- Authors
-
Ashish Ankola, David K. Bailly, Ron Reeder, Katherine Cashen, Heidi J. Dalton, Stephen J. Dolgner, Myke Federman, Rod Ghassemzadeh, Adam S. Himebauch, Asavari Kamerkar, Josh Koch, Joseph G. Kohne, Margaret Lewen, Neeraj Srivastava, R.C. Willett, Peta AlexanderList of authors in order
- Landing page
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https://doi.org/10.3389/fcvm.2021.812881Publisher landing page
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https://www.frontiersin.org/articles/10.3389/fcvm.2021.812881/pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/articles/10.3389/fcvm.2021.812881/pdfDirect OA link when available
- Concepts
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Medicine, Extracorporeal membrane oxygenation, Odds ratio, Clotting factor, Cardiac surgery, Activated clotting time, Cardiopulmonary bypass, Complication, Thrombosis, Aortic cross-clamp, Surgery, Internal medicine, CardiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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10Total citation count in OpenAlex
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2025: 1, 2024: 4, 2023: 4, 2022: 1Per-year citation counts (last 5 years)
- References (count)
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17Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.also | 208 |
| abstract_inverted_index.cell | 95 |
| abstract_inverted_index.day. | 102 |
| abstract_inverted_index.from | 76, 112, 157, 239, 266 |
| abstract_inverted_index.most | 148 |
| abstract_inverted_index.odds | 104, 242 |
| abstract_inverted_index.site | 212 |
| abstract_inverted_index.time | 174 |
| abstract_inverted_index.were | 79, 105, 123, 147, 154, 163, 186, 207, 247, 287, 296 |
| abstract_inverted_index.with | 27, 65, 117, 126, 166, 188, 210, 232, 251, 281, 289 |
| abstract_inverted_index.(26%) | 152 |
| abstract_inverted_index.(61%) | 128 |
| abstract_inverted_index.(ACT) | 175 |
| abstract_inverted_index.0.02; | 197 |
| abstract_inverted_index.0.05) | 229 |
| abstract_inverted_index.0.77, | 199 |
| abstract_inverted_index.1.75, | 224 |
| abstract_inverted_index.2.82, | 255 |
| abstract_inverted_index.3.32, | 269 |
| abstract_inverted_index.There | 122 |
| abstract_inverted_index.aimed | 16 |
| abstract_inverted_index.blood | 94 |
| abstract_inverted_index.heart | 137 |
| abstract_inverted_index.ml/kg | 98 |
| abstract_inverted_index.study | 133 |
| abstract_inverted_index.those | 263 |
| abstract_inverted_index.(BATE) | 51 |
| abstract_inverted_index.(CPB). | 160 |
| abstract_inverted_index.(ECMO) | 10 |
| abstract_inverted_index.(ELSO) | 58 |
| abstract_inverted_index.0.001) | 219 |
| abstract_inverted_index.0.023) | 261 |
| abstract_inverted_index.bypass | 159 |
| abstract_inverted_index.common | 4 |
| abstract_inverted_index.during | 29 |
| abstract_inverted_index.events | 86, 130, 162, 190, 206, 278 |
| abstract_inverted_index.ranges | 170, 303 |
| abstract_inverted_index.years) | 64 |
| abstract_inverted_index.0.004). | 204 |
| abstract_inverted_index.0.047). | 275 |
| abstract_inverted_index.Network | 44 |
| abstract_inverted_index.Support | 56 |
| abstract_inverted_index.assays. | 306 |
| abstract_inverted_index.cardiac | 13, 21, 31, 68, 142, 233, 282 |
| abstract_inverted_index.centers | 78 |
| abstract_inverted_index.central | 221, 252, 290 |
| abstract_inverted_index.cohort. | 134 |
| abstract_inverted_index.common, | 149 |
| abstract_inverted_index.disease | 138 |
| abstract_inverted_index.levels. | 178 |
| abstract_inverted_index.managed | 70 |
| abstract_inverted_index.medical | 143 |
| abstract_inverted_index.onwards | 116 |
| abstract_inverted_index.primary | 67 |
| abstract_inverted_index.&lt; | 218 |
| abstract_inverted_index.(75/187, | 145 |
| abstract_inverted_index.(94/187, | 139 |
| abstract_inverted_index.(CPCCRN) | 45 |
| abstract_inverted_index.Bleeding | 1, 46, 103, 161, 205, 241, 277 |
| abstract_inverted_index.Critical | 41 |
| abstract_inverted_index.Methods: | 60 |
| abstract_inverted_index.Registry | 82 |
| abstract_inverted_index.Research | 43 |
| abstract_inverted_index.Results: | 121 |
| abstract_inverted_index.assessed | 106 |
| abstract_inverted_index.bleeding | 28, 85, 129, 189 |
| abstract_inverted_index.children | 62, 125, 280 |
| abstract_inverted_index.clinical | 211 |
| abstract_inverted_index.clotting | 173 |
| abstract_inverted_index.criteria | 83 |
| abstract_inverted_index.directly | 156, 265 |
| abstract_inverted_index.elevated | 182 |
| abstract_inverted_index.identify | 18 |
| abstract_inverted_index.included | 73, 87 |
| abstract_inverted_index.logistic | 119 |
| abstract_inverted_index.membrane | 8 |
| abstract_inverted_index.patients | 153, 250 |
| abstract_inverted_index.platelet | 177 |
| abstract_inverted_index.strategy | 292 |
| abstract_inverted_index.surgical | 24, 235 |
| abstract_inverted_index.Pediatric | 40 |
| abstract_inverted_index.Registry. | 59 |
| abstract_inverted_index.achieving | 167, 300 |
| abstract_inverted_index.activated | 172 |
| abstract_inverted_index.analysis, | 181 |
| abstract_inverted_index.analyzed. | 80 |
| abstract_inverted_index.bleeding, | 91 |
| abstract_inverted_index.combining | 34 |
| abstract_inverted_index.diagnoses | 144, 283 |
| abstract_inverted_index.diagnosis | 69 |
| abstract_inverted_index.increased | 248 |
| abstract_inverted_index.modulated | 298 |
| abstract_inverted_index.patients. | 14 |
| abstract_inverted_index.pediatric | 12, 30 |
| abstract_inverted_index.pulmonary | 88 |
| abstract_inverted_index.supported | 284 |
| abstract_inverted_index.variables | 25 |
| abstract_inverted_index.&gt;80 | 97 |
| abstract_inverted_index.0.6–0.9, | 201 |
| abstract_inverted_index.1.0–1.3, | 194 |
| abstract_inverted_index.1.0–3.1, | 226 |
| abstract_inverted_index.Thrombosis | 48 |
| abstract_inverted_index.associated | 26, 165, 187, 209, 288 |
| abstract_inverted_index.cannulated | 155, 264 |
| abstract_inverted_index.congenital | 136 |
| abstract_inverted_index.databases, | 37 |
| abstract_inverted_index.diagnoses, | 22 |
| abstract_inverted_index.diagnosis, | 234 |
| abstract_inverted_index.fibrinogen | 185 |
| abstract_inverted_index.monitoring | 305 |
| abstract_inverted_index.practices, | 20 |
| abstract_inverted_index.(&lt;19 | 63 |
| abstract_inverted_index.2.0–11.1, | 216 |
| abstract_inverted_index.Background: | 0 |
| abstract_inverted_index.cannulation | 222, 238, 253, 291 |
| abstract_inverted_index.complexity, | 236 |
| abstract_inverted_index.established | 36 |
| abstract_inverted_index.oxygenation | 9 |
| abstract_inverted_index.regression. | 120 |
| abstract_inverted_index.therapeutic | 169, 302 |
| abstract_inverted_index.transfusion | 96 |
| abstract_inverted_index.1.15–7.08, | 258 |
| abstract_inverted_index.Conclusions: | 276 |
| abstract_inverted_index.Organization | 57 |
| abstract_inverted_index.complication | 5 |
| abstract_inverted_index.intracranial | 90 |
| abstract_inverted_index.1.02–11.61, | 272 |
| abstract_inverted_index.Biventricular | 135 |
| abstract_inverted_index.Collaborative | 39 |
| abstract_inverted_index.coagulopathy, | 294 |
| abstract_inverted_index.multivariable | 118, 180 |
| abstract_inverted_index.pre-specified | 168, 301 |
| abstract_inverted_index.Extracorporeal | 54 |
| abstract_inverted_index.extracorporeal | 7 |
| abstract_inverted_index.anticoagulation | 19 |
| abstract_inverted_index.cardiopulmonary | 158 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5015956561 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 16 |
| corresponding_institution_ids | https://openalex.org/I181547552 |
| citation_normalized_percentile.value | 0.68085285 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |