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Incidence of Cannula-Associated Deep Vein Thrombosis After Veno-Venous Extracorporeal Membrane Oxygenation

Menaker, Jay*; Tabatabai, Ali*; Rector, Raymond; Dolly, Katelyn; Kufera, Joseph; Lee, Eugenia*; Kon, Zachary§; Sanchez, Pablo§; Pham, Si§; Herr, Daniel L.*; Mazzeffi, Michael; Rabinowitz, Ronald P.*; O’Connor, James V.*; Stein, Deborah M.*; Scalea, Thomas M.*

doi: 10.1097/MAT.0000000000000539
Adult Circulatory Support

Limited literature regarding the incidence of cannula-associated deep vein thrombosis (CaDVT) after veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty-eight patients were admitted between August 2014 and January 2016 to the Lung Rescue Unit were included in the study. Protocolized anticoagulation levels (partial thromboplastin time [PTT] 45–55 seconds) and routine post decannulation DVT screening were in place during the study period. Forty-one (85.4%) patients had CaDVT. Of those with CaDVT, 31 (76%) patients were treated with full anti-coagulation therapy. Thirty-four (76%) patients with right internal jugular (RIJ) cannulation had CaDVT at cannula site. Twenty-five (61%) patients had CaDVT in the lower extremity (18 associated right femoral vein cannulation and 7 left femoral vein cannulation). Eighteen (44%) patients had both upper and lower extremity CaDVT. Overall, patients with CaDVT tended to be older, have a higher body mass index (BMI), and on ECMO longer (p = NS). Mean PTT during time on ECMO between patients that did and did not have CaDVT did not differ. No clinical evidence of pulmonary embolism (PE) was seen.

From the *Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Peri-Operative Service, University of Maryland Medical Center, Baltimore, Maryland; National Study Center for Trauma and EMS, University of Maryland School of Medicine, Baltimore, Maryland; §Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland; and Department of Anesthesia, University of Maryland School of Medicine, Baltimore, Maryland.

Submitted for consideration september 2016; accepted for publication in revised form january 2017.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Jay Menaker, Department of Surgery, University of Maryland School of Medicine, Lung Rescue Unit (LRU), R Adams Cowley Shock Trauma Center, Baltimore, MD. Email: jmenaker@umm.edu.

Copyright © 2017 by the American Society for Artificial Internal Organs