Venous thrombosis of the cannulated vein is relatively common after venovenous extracorporeal membrane oxygenation (ECMO). Risser et al identified risk factors for its occurrence. The authors are from University Hospital Regensburg in Germany.
Patient selection: adult with acute respiratory failure treated with venovenous extracorporeal membrane oxygenation (ECMO)
Thrombosis was indicated by a luminal occlusion greater than 50%.
Risk factors for venous thrombosis associated with venous cannula (from multivariate analysis):
(1) persistent elevation of plasma D-dimer after decannulation
(2) reduced systemic anticoagulation
where:
• Histories of previous thrombosis or hypercoagulable state do not appear to be a variable included in the analysis.
A patient on unfractionated heparin is at risk when the aPTT is <= 50 seconds.
Monitoring of the cannula sites for thrombus formation is recommended using duplex ultrasonography.
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