Oseltamivir Improved Thrombocytopenia During Veno-Arterial Extracorporeal Membrane Oxygenation in Adults With Refractory Cardiac Failure: A Single-Center Retrospective Real-World Study

Frontiers in Cardiovascular Medicine

article

Yuan Li¹  Lin Wang¹  Jianning Zhang¹  Hui Han¹  Han Liu¹  Chaoyang Li¹  Haipeng Guo¹  Yuguo Chen¹  Xiaomei Chen¹ 

[1] Qilu Hospital, Shandong University

关键词: extracorporeal membrane oxygenation;    veno-arterial;    thrombocytopenia;    platelets;    cardiac failure;    oseltamivir;    desialylation;   

DOI  :  10.3389/fcvm.2021.645867

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: Severe thrombocytopenia is a common complication of extracorporeal membrane oxygenation (ECMO). Oseltamivir can be used to treat infection-associated thrombocytopenia. Objective: To evaluate the effect of oseltamivir on attenuating severe thrombocytopenia during ECMO. Methods: This was a single-center real-world study in critically ill patients supported with venous-arterial extracorporeal membrane oxygenation (VA-ECMO). Patients suspected or confirmed with influenza received oseltamivir according to the Chinese guidelines. Thrombocytopenia and survival were compared between the oseltamivir-treated and untreated group. The factors associated with survival were analyzed by multivariable Cox analysis. Results: A total of 82 patients were included. All patients developed thrombocytopenia after initiating VA-ECMO. Twenty-three patients received oseltamivir (O + group), and 59 did not use oseltamivir (O − group). During the first 8 days after VA-ECMO initiation, the platelet count in the O + group was higher than that in the O − group (all P < 0.05). The patients in the O + group had a higher median nadir platelet count (77,000/μl, 6,000–169,000/μl) compared with the O − group (49,000/μl, 2,000–168,000/μl; P = 0.04). A nadir platelet count of <50,000/μl was seen in 26% of the patients in the O + group, compared with 53% in the O − group ( P = 0.031). No significant difference in survival from cardiac failure was seen between the O + and O − group (48 vs. 56%, P = 0.508). The Sequential Organ Failure Assessment (SOFA) score on initiation of VA-ECMO were independently associated with survival (OR = 1.12, 95% confidence interval (95% CI): 1.02–1.22, P = 0.015). Conclusions: Oseltamivir could ameliorate VA-ECMO-related thrombocytopenia. These findings suggested the prophylactic potential of oseltamivir on severe thrombocytopenia associated with the initiation of VA-ECMO.

【 授权许可】

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