Figure 4. Device-induced hyperfibrinolysis as a reason for an elective system-exchange.

Timeline of respective values before and after sytem-exchange, “day 0” =  system-exchange. Patients with system-exchange (black dots, n = 8): (B) Fibrinogen (FG) concentration decreased significantly below the normal value of 200 mg/dl, while (A) levels of D-dimers visually increased and (C) platelet count decreased (both not statistically significant). After system-exchange the coagulation disorder could be stopped. Circles: Patients without exchange and comparable support time (≥12 days, n = 36). Data at day 9 after starting ECMO therapy were set as “day 0”, other values depicted accordingly. Data are presented as median and interquartile range. *, p≤0.05 compared to day 0 (refers to black dots). Differences between patients with and without exchange on respective days (a, p≤0.001; b, p≤0.01; c, p≤0.05).