Analysis Of Risk Factors Of Thrombosis During Extracorporeal Membrane Oxygenation Therapy

Objective:By monitoring the dynamic changes of different detection indexes before and after thrombosis during extracorporeal membrane oxygenation(ECMO)support treatment,the diagnostic indexes of thrombosis during the treatment of patients with extracorporeal membrane oxygenation(ECMO)were explored,and a more accurate detection model for the diagnosis of thrombosis was constructed to provide reference for the prevention,diagnosis and treatment of thrombosis in patients with ECMO.Method:Retrospectively collected patients who were hospitalized in the EICU of the Emergency Department of the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2019 to December 2020 and received ECMO support treatment,and had thrombosis events during ECMO treatment.The patients were collected from the first day of ECMO support treatment until the time of thrombosis was observed.The daily coagulation function,blood routine and other test data were collected,and the location and time of thrombosis were recorded.Grouped according to the indicators before and after thrombosis during treatment.The changes of the test indexes between the two groups were compared and analyzed.The sensitive indicators related to thrombosis were calculated,and a detection scheme capable of accurately diagnosing thrombosis was constructed.Result:During the study period,a total of 31 patients who received ECMO treatment met the inclusion criteria.There were 24 cases of thrombosis in vitro and 7 cases of thrombosis in vivo.Univariate analysis showed that after thrombosis,fibrin degradation products(FDP)and D-dimer(DD)increased significantly,while white blood cell(WBC),hemoglobin(HBG)and platelet count(PLT)decreased significantly.The difference was statistically significant(P<0.05).Binary Logistic regression analysis showed that D-dimer and PLT were important diagnostic indicators of thrombosis in patients with ECMO.ROC curve showed that when D-dimer>8.155ug/L and PLT<105.5x10~9/L,the sensitivity and specificity of this scheme in the diagnosis of thrombosis in ECMO patients were 80.6%and 87.1%(AUC:0.879,P<0.01).Conclusion:1.D-dimer and platelet count are independent risk factors for the diagnosis of thrombosis in patients with ECMO.2.D-dimer combined with platelet count can better diagnose thrombosis in patients with ECMO,with a sensitivity of 80.6%and a specificity of 87.1%.