{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Kartika T"],"funding":["NHLBI NIH HHS"],"pagination":["566-576"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC11034845"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["112(4)"],"pubmed_abstract":["<h4>Objectives</h4>We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO).<h4>Methods</h4>We performed a retrospective cohort study of adult patients placed on V-V ECMO with intravenous anticoagulation with either heparin or bivalirudin. Time to thrombotic event and major bleed were analyzed in addition to related outcomes.<h4>Results</h4>We identified 95 patients placed on V-V ECMO: 61 receiving heparin, 34 bivalirudin. The bivalirudin group had a higher rate of severe COVID-19, higher BMI, and longer ECMO duration. Despite this, bivalirudin was associated with reduced risk of thrombotic event (HR 0.14, 95% CI 0.06-0.32, p < .001) and increased average lifespan of the circuit membrane lung (16 vs. 10 days, p = 0.004). While there was no difference in major bleeding, the bivalirudin group required fewer transfusions of packed red blood cells and platelets per 100 ECMO days (means of 13 vs. 39, p = 0.004; 5 vs. 19, p = .014, respectively). Lastly, the bivalirudin group had improved survival to ECMO decannulation in univariate analysis (median OS 53 vs. 26 days, p = .015).<h4>Conclusions</h4>In this real-world analysis of bivalirudin versus heparin, bivalirudin is a viable option for V-V ECMO and associated with lower risk of thrombotic complications and fewer transfusion requirements."],"journal":["European journal of haematology"],"pubmed_title":["Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin."],"pmcid":["PMC11034845"],"funding_grant_id":["T32 HL083808","R01 HL144113","R01 HL151367","R01 HL101972"],"pubmed_authors":["McCarty OJT","Pfeffer M","Hinds MT","Zakhary B","Beardshear R","Kartika T","Zonies D","Oetken HJ","Migneco G","Moore K","Mathews R","Shatzel JJ","Kaempf AJ","DeLoughery TG","Bundy T","Case J"],"additional_accession":[]},"is_claimable":false,"name":"Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin.","description":"<h4>Objectives</h4>We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO).<h4>Methods</h4>We performed a retrospective cohort study of adult patients placed on V-V ECMO with intravenous anticoagulation with either heparin or bivalirudin. Time to thrombotic event and major bleed were analyzed in addition to related outcomes.<h4>Results</h4>We identified 95 patients placed on V-V ECMO: 61 receiving heparin, 34 bivalirudin. The bivalirudin group had a higher rate of severe COVID-19, higher BMI, and longer ECMO duration. Despite this, bivalirudin was associated with reduced risk of thrombotic event (HR 0.14, 95% CI 0.06-0.32, p < .001) and increased average lifespan of the circuit membrane lung (16 vs. 10 days, p = 0.004). While there was no difference in major bleeding, the bivalirudin group required fewer transfusions of packed red blood cells and platelets per 100 ECMO days (means of 13 vs. 39, p = 0.004; 5 vs. 19, p = .014, respectively). Lastly, the bivalirudin group had improved survival to ECMO decannulation in univariate analysis (median OS 53 vs. 26 days, p = .015).<h4>Conclusions</h4>In this real-world analysis of bivalirudin versus heparin, bivalirudin is a viable option for V-V ECMO and associated with lower risk of thrombotic complications and fewer transfusion requirements.","dates":{"release":"2024-01-01T00:00:00Z","publication":"2024 Apr","modification":"2025-07-04T03:06:06.184Z","creation":"2025-07-04T03:06:06.184Z"},"accession":"S-EPMC11034845","cross_references":{"pubmed":["38088062"],"doi":["10.1111/ejh.14146"]}}