Relationship between prothrombin time-international normalized ratio and extracorporeal membrane oxygenation related hemorrhagic complications in patients in cardiac surgical ICU
Chen Qin
Liu Jidong
Li Wenting
Huang Wanzhen
Zhu Li
Abstract：Objective To analyze the occurrence of hemorrhagic complications related to extracorporeal membrane oxygenation(ECMO)and difference in coagulation indexes in patients in cardiac surgical intensive care unit(ICU).Methods The patients(n=62)admitted to ICU after first cardiac surgery and supported by veno-arterial(VA)-ECMO were selected from Oct.2021 to Apr.2023.After collected blood samples at 7 am on the day of cardiac surgery,activated partial thromboplastin time(APTT),prothrombin time-international normalized ratio(PT-INR),D-dimer(D-D)and platelet count(PLT)were detected.The occurrence of hemorrhagic complications was recorded.Results The hemorrhagic complications occurred in 34 patients(54.84%),respiratory tract hemorrhage was the most common hemorrhagic complication(58.82%),and most of the hemorrhagic complications occurred within 3～8 d.PT-INR was significantly higher in patients with hemorrhagic complications than that in patients without hemorrhagic complications(P<0.001),and APTT,D-dimer,and PLT had no statistical difference(P>0.05).In predicting occurrence of hemorrhagic complications in patients in cardiac surgical ICU after ECMO,AUC of ROC curve was 0.953(95%CI:0.867～0.990).The results of multi-factor Logistic regression analysis showed that,after adjusting for ECMO use time,PT-INR was still an independent predictive factor for occurrence of hemorrhagic complications in patients in cardiac surgical ICU after ECMO.Conclusion PT-INR is higher in patients with hemorrhagic complications,and PT-INR can be used to assist in analyzing the risk of hemorrhagic complications in patients receiving VA-ECMO treatment.
Keywords：Extracorporeal membrane oxygenationCardiac surgeryProthrombin time-international normalized ratioHemorrhagic complications
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 356-359 )