Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution
Objective: Extracorporeal membrane oxygenation (ECMO) support for patients with cardiac or respiratory failure has been increasingly used by advanced critical care practitioners. The thromboembolic complications of ECMO have been extensively discussed and researched; however, research and discussion...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Journal of Vascular Surgery Cases and Innovative Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468428723000308 |
| _version_ | 1797797165673742336 |
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| author | Alexandra Tedesco, MD Monica Majumdar, MD, MPH Jamel P. Ortoleva, MD Christine Nayar, MD Masashi Kawabori, MD Payam Salehi, MD, PhD Ali Irshad, MD |
| author_facet | Alexandra Tedesco, MD Monica Majumdar, MD, MPH Jamel P. Ortoleva, MD Christine Nayar, MD Masashi Kawabori, MD Payam Salehi, MD, PhD Ali Irshad, MD |
| author_sort | Alexandra Tedesco, MD |
| collection | DOAJ |
| description | Objective: Extracorporeal membrane oxygenation (ECMO) support for patients with cardiac or respiratory failure has been increasingly used by advanced critical care practitioners. The thromboembolic complications of ECMO have been extensively discussed and researched; however, research and discussion on the development, risks, and management of cannulae-associated fibrin sheaths are lacking. Methods: Institutional review board approval was not required. We have presented three cases detailing the identification and individualized management of ECMO-associated fibrin sheaths at our institution. The three patients provided written informed consent for the report of their case details and imaging studies. Results: Of our three patients with ECMO-associated fibrin sheaths, two were managed successfully with anticoagulation alone. One could not receive anticoagulation therapy and underwent inferior vena cava filter placement. Conclusions: Fibrin sheath formation around indwelling ECMO cannulae is an unresearched complication of ECMO cannulation. We would recommend an individualized approach to the management of these fibrin sheaths and have provided three examples of successful management. |
| first_indexed | 2024-03-13T03:45:06Z |
| format | Article |
| id | doaj.art-ebdabc3a1b174e81a6d55bf57be42721 |
| institution | Directory Open Access Journal |
| issn | 2468-4287 |
| language | English |
| last_indexed | 2024-03-13T03:45:06Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Vascular Surgery Cases and Innovative Techniques |
| spelling | doaj.art-ebdabc3a1b174e81a6d55bf57be427212023-06-23T04:43:35ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872023-06-0192101121Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institutionAlexandra Tedesco, MD0Monica Majumdar, MD, MPH1Jamel P. Ortoleva, MD2Christine Nayar, MD3Masashi Kawabori, MD4Payam Salehi, MD, PhD5Ali Irshad, MD6Department of General Surgery, Tufts Medical Center, Boston, MA; Correspondence: Alexandra Tedesco, MD, Department of Surgery, Tufts Medical Center, 800 Washington St, Box 437, Boston, MA 02111Department of General Surgery, Tufts Medical Center, Boston, MADepartment of Anesthesia, Tufts Medical Center, Boston, MADepartment of Pulmonary, Critical Care, and Sleep Medicine, Jefferson Abington Hospital, Abington, PADepartment of Cardiothoracic Surgery, Tufts Medical Center, Boston, MADepartment of Vascular Surgery, Tufts Medical Center, Boston, MADepartment of Cardiothoracic Surgery, Vanderbilt University Medical Center, Nashville, TNObjective: Extracorporeal membrane oxygenation (ECMO) support for patients with cardiac or respiratory failure has been increasingly used by advanced critical care practitioners. The thromboembolic complications of ECMO have been extensively discussed and researched; however, research and discussion on the development, risks, and management of cannulae-associated fibrin sheaths are lacking. Methods: Institutional review board approval was not required. We have presented three cases detailing the identification and individualized management of ECMO-associated fibrin sheaths at our institution. The three patients provided written informed consent for the report of their case details and imaging studies. Results: Of our three patients with ECMO-associated fibrin sheaths, two were managed successfully with anticoagulation alone. One could not receive anticoagulation therapy and underwent inferior vena cava filter placement. Conclusions: Fibrin sheath formation around indwelling ECMO cannulae is an unresearched complication of ECMO cannulation. We would recommend an individualized approach to the management of these fibrin sheaths and have provided three examples of successful management.http://www.sciencedirect.com/science/article/pii/S2468428723000308COVID-19ECMOFibrin sheathThrombectomyThromboembolic complications |
| spellingShingle | Alexandra Tedesco, MD Monica Majumdar, MD, MPH Jamel P. Ortoleva, MD Christine Nayar, MD Masashi Kawabori, MD Payam Salehi, MD, PhD Ali Irshad, MD Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution Journal of Vascular Surgery Cases and Innovative Techniques COVID-19 ECMO Fibrin sheath Thrombectomy Thromboembolic complications |
| title | Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution |
| title_full | Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution |
| title_fullStr | Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution |
| title_full_unstemmed | Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution |
| title_short | Variance in management of extracorporeal membrane oxygenation-associated fibrin sheaths at a single institution |
| title_sort | variance in management of extracorporeal membrane oxygenation associated fibrin sheaths at a single institution |
| topic | COVID-19 ECMO Fibrin sheath Thrombectomy Thromboembolic complications |
| url | http://www.sciencedirect.com/science/article/pii/S2468428723000308 |
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