Table 3.
Characteristics of the studies analysed, including patient cohorts, anticoagulant thromboprophylaxis and thrombotic complications
| Study | Total no. patients | Age mean (SD) or median (IQR) | Gender | Diabetes n (%) | BMI mean (SD) or median (IQR) | Patients on ECMO n (%) | Patients on thromboprophylaxis on admission n (%) | Type of thromboprophylaxis | Patients on therapeutic anticoagulation n (%) | Routine screening for VTE | Patients with any venous thrombotic complications n (%) | Patients with PE n (%) | Patients with DVT n (%) | Other thrombotic complicationsn (%) | Patients with arterial thrombotic events (%) | Patients with any reported thrombotic events n (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Piazza et al. [36] | 170 | 61.7 (15.8) | M 106 (62%) | 66/170 (39) | 30.3 (5.7) | NA | 89% | LMWH UFH Rivaroxaban | NA | No | 46/170 (27) | 3/170 (2) | 39/170 (23) | Catheter/device-related thrombosis: 30/39 (77) Catheter/device-related arterial thrombosis: 11/170 (7) | 14/170 (8) | 60 (35) |
| Longhitano et al. [32] | 62 | NA | NA | NA | NA | NA | 100% | Enoxaparin 100U/kg/24 h > 80 kg: Enoxaparin 5000U b.i.d | 0 (0) | No | 12/62 (19) | 11/62 (18) | 4/62 (6) | NA | NA | 12/62 (19) |
| Shah et al. [52] | 187 | 57 (49–64) | M 124 (66%) | 54/187 (30) | 28 (25–32) | 5 (3) | 151/187 (81) | LMWH UFH | 27/187 (14) | No | 56/187 (30) | 42/187 (23%) | 22/187 (12) | Extracorporeal circuit disruption: 23 (12) | 25/187 (13) | 81/187 (43%) |
| Bilaloglu et al. [41] | 829 | NA | NA | NA | NA | NA | ‘Most received thromboprophylaxis’ | NA | NA | No | 113/829 (14) | 52/829 (6) | 78/829 (9) | Limb ischaemia, renal and splenic infarcts, PVT: 18/829 (2) | 154/829 (19) | 224/829 (29) |
| Bemtgen et al. [40] | 11 | 59 (50–61) | M 7 (64%) | NA | 27.8 (25.1–33.9) | 11 (100) | UFH on ECMO | UFH on ECMO (argatroban if HIT) | 11/11 | No | NA | NA | NA | Extracorporeal circuit disruption: 7/11 (64) | NA | 7/11 (64) |
| Yuriditsky et al. [51] | 64 | 64 (57–71) | M 46 (72%) | NA | NA | NA | 9/64 (14) | Enoxaparin UFH | 55/64 (86) | No | 20/64 (31) | 1/64 (2) | 19/64 (30) | Clot in transit in RV: 1/64 (2) | NA | 20/64 (31) |
| Hekimian et al. [35] | 51 | NA | NA | NA | NA | NA | NA | NA | NA | No | 8/51 (16) | 8/51 (16) | NA | NA | NA | 8/51 (16) |
| Cui et al. [33] | 81 |
59.9 (14.1) |
M 37 (46%) | 8/81 (10) | NA | NA | NA | NA | NA | No | 20/81 (25) | NA | 20/81 (25) | NA | 20/81 (25) | |
| Helms et al. [38] | 150 | 63 (53–71) | M 122 (81%) | 30/150 (20) | NA | 12/150 (8) | 105/150 (70) | LMWH: 4,000 IU/day UFH: 5–8 U/kg/h | 45/150 (30) | No | 59/150 (39) | 25/150 (17) | 3/150 (2) | Circuit thrombosis (RRT): 28/29 (97); ECMO pump thrombosis: 3/12 (25) | 4/150 (3) | 63/150 (42) |
| Klok et al. [10, 21] | 184 | 64 (12) | M 139 (76%) | NA | NA | NA | 167/184 (91) (all others receiving full anticoagulation) | Nadroparin (dose dependent on patient weight and recruiting site) | 17/184 (9) | No | 68/184 (37) | 65/184 (35) | 1/184 (0.5) | Catheter related thrombosis: 2/184 (1) | 7/184 (4) | 75/184 (41) |
| Poissy et al. [34] | 107 | NA | NA | NA | NA | NA | NA | LMWH or UFH | NA | No | 24/107 (22) | 22/107 (21) | 5/107 (5) | NA | NA | 24/107 (22) |
| Thomas et al..[37] | 63 | 59 (13) | M 44(70%) | NA | NA | NA | 63/63 (100) | Dalteparin | NA | No | 6/63 (10) | 5/63 (8) | 0/63 (0) | Line thrombosis: 1/51 (2) | 2/63 (3) | 8/63 (13) |
| Lodigiani et al. [53] | 61 | 61 (55–69) | M 49 (80%) | 11/61 (18) | Obesity: 28% | NA | 59/61 (97) | LMWH | 2/61 (3) | No | 4/61 (7) | 2/61 (3) | 1/61 (2) | Line thrombosis:1/61 (2) | 4/61 (7) | 8/61 (13) |
| Beyls et al. [39] | 12 | 62 (56–66) | M 10 (83%) | NA | 29.5 (29.3 – 32.4) | 12/12 (100) | UFH on ECMO | UFH on ECMO | 12/12 (100) | No | 10/12 (83) | 1/12 (8) | 6/12 (50) | Cannula thrombosis 2/12 (17); ECMO Oxygenator thrombosis 1/12 (8) | NA | 10/12 (83) |
| Maatman et al. [56] | 109 | 61 (16) | M 62 (57%) | 43/109 (39) | 34.8 (11.8) | NA | 102/109 (94) | UFH: 5,000 IU S/C t.d.s. Enoxaparin: 40 mg S/C o.d. or 30 mg S/C b.i.d | 7/109 (6) | No | 31/109 (28) | 5/109 (5) | 29/109 (27) | Line thrombosis:5/109 (5) | NA | 31/109 (28) |
| Fraissé et al. [54] | 92 | 61 (55–70) | M 73 (79%) | 35/92 (38) | 30 (26–35) | NA | 43/92 (47) | LMWH | 49/92 (53) | No | 31/92 (34) | 25/92 (27) | 12/92 (13) | NA | 8/92 (9) | 37/92 (42) |
| Al Samkari et al. [55] | 144 | 65 (32–97) | M 93 (65%) | 58/144 (40) | Obesity 62 (43%) | NA | 124/144 (86) | Unknown | 18/144 (13) | No | 11/144 (8) | NA | NA | Line thrombosis 2/144 (1); Circuit thrombosis (RRT): 8/12 (67) | 8/144 (6) | 26/144 (18) |
| Hippensteel et al. [59] | 91 | NA | M 53 (58%) | 28/91 (31) | NA | 0/91 (0) | NA | Unknown | At start: none; later 24 anticoagulated for AF (n = 4) or unconfirmed VTE/hypercoagulability (n = 20) | No | 24/91 (26) | 5/91 (6) | 11/91 (12) | Internal jugular vein thrombus 8 (9) | NA | 24/91 (26) |
| Desborough et al. [57] | 66 | 59 (49–66) | M 48 (73%) | 27/66 (41) | 28 (24–34) | 8/66 (27) | 55/66 (83) | Dalteparin (adjusted to weight and renal function) | 11/66 (17) | No | 10 / 66 (15) | 5/66 (8) | 6/66 (9) | NA | NA | 10/66 (15) |
| Middeldorp et al. [30] | 75 | 62 (10) | M 58 (77%) | NA | 27 (24–29) | NA | 68/75 (91) | Nadroparin with weight adjustment. Dose increased mid-study for ICU patients | 7 (9.3) | Screening in 38/ 75 (51%) patients | 35/75 (47) | 11/75 (15) | 24/75 (32) | NA | NA | 35/75 (47) |
| Parzy et al. [24] | 13 | 50 (43–62) | M 9 (70%) | 2/13 (15) | 31 (27–36) | 13/13 (100) | UFH on ECMO | UFH on ECMO (argatroban if HIT) | 11/11 (100) | Yes (Contrast CT) | 13/13 (100) | 3/13 (23) | 11/13 (85) | Oxygenator thrombosis: 1/13 (8) centrifugal pump thrombosis: 1/13 (8) | NA | 13/13 (100) |
| Mak et al. [23] | 51 | 45 (26–66) | M 38 (75%) | NA | NA | 51 (100) | NA | NA | NA | Yes (CTPA) | NA | 18/51 (35) | NA | NA | NA | 18/51 (35) |
| Longchamp et al. [22] | 25 | 68 (11) | 16 (64%) | 1 (4) | 27.5 (4.6) | NA | 23/25 (92) | Enoxaparin (according to weight) UFH | 2/25 (8) | Yes | 8/25 (32) | 5/25 (20) | 6/25 (24) | NA | NA | 8/25 (32) |
| Voicu et al. [27] | 92 | 62 (53–69) | M 66 (72%) | 30 (33) | 28 (25–32) | NA | 68 (74) | LMWH UFH | 24 (26) | Yes | 48/92 (52) | 5/92 (5) | 44/92 (48) | NA | NA | 48/92 (52) |
| Criel et al. [29] | 30 | 64.5 (11.8) | M 20 (67%) | 5/30 (17) | 30.3 (5.4) | 0/30 (0) | 30/30 | Exoxaparin 40 mg × 2 (or 60 mg × 2 if weight > 100 kg) | 0/30 (0) | Yes | 4/30 (13) | NA | 4/30 (13) | NA | NA | 4/30 (13) |
| Llitjos et al. [26] | 26 | 68 (51.5–74.5) | M 20 (77%) | NA | 30.2 (25.5 – 33.5) | 2/26 (8) | 8/26 (31) | LMWH | 18/26 (69) | Yes | 24/26 (92) | 6/26 (23) | 18/26 (69) | NA | NA | 24/26 (92) |
| Ren et al. [28] | 48 | 70 (62–80) | M 26 (54%) | 13/48 (27) | NA | NA | 47/48 (98) | LMWH | 0/48 (0) | Yes | 41/48 (85) | NA | 41/48 (85) | NA | NA | 41/48 (85) |
| Nahum et al. [25] | 34 | 62.2 (8.6) | M 25 (74%) | 15/34 (44) | 31.4 (9.0) | 4/34 (12) | 34/34 (100) | Unknown | 0/34 (0) | Yes | 27/34 (79) | NA | 27/34 (79) | NA | NA | 27/34 (79) |
AF atrial fibrillation, BMI body mass index, b.i.d. = bis in die (twice daily), DVT deep venous thrombosis, ECMO extracorporeal membrane oxygenation, IQR interquartile range, i.v.i. intravenous infusion, LMWH = low molecular weight heparin, M male, NA not available, o.d. once daily, PE pulmonary embolism, RRT renal replacement therapy, S/C subcutaneous, SD standard deviation, t.d.s. ter in die (three times daily), UFH unfractionated heparin, VTE venous thromboembolism