{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T04:25:03Z","timestamp":1743567903189,"version":"3.40.3"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["JP22fk0108654"],"award-info":[{"award-number":["JP22fk0108654"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Complications during veno-venous extracorporeal membrane oxygenation (VV-ECMO) are associated with in-hospital mortality. Asian patients on extracorporeal membrane oxygenation (ECMO) have higher risks of bleeding and in-hospital mortality than Caucasian patients. This study aimed to characterize and identify bleeding complications and their associated factors related to in-hospital mortality in patients with severe coronavirus disease 2019 (COVID-19) requiring VV-ECMO in Japan.<\/jats:p><jats:p>In this retrospective observational analysis, the prospective nationwide multicenter registry was used to track real-time information from intensive care units throughout Japan during the COVID-19 pandemic. VV-ECMO patients' registry data between February 1, 2020 and October 31, 2022 were used.<\/jats:p><jats:p>This study included 441 patients; 178 (40%) had bleeding complications in the following sites: 20% at the cannulation site, 16% in the gastrointestinal tract, 16% in the ear\u2013nose\u2013throat, 13% at the tracheostomy site, 9% intrathoracic, 6% intracranial, and 5% in the iliopsoas. Anticoagulation was discontinued in &gt;50% of patients with intracranial, iliopsoas, and gastrointestinal tract bleeding. ECMO was discontinued in one-third of patients with intracranial, intramuscular, and iliopsoas hemorrhages. Multivariable logistic regression analysis revealed that only gastrointestinal tract bleeding was associated with in-hospital mortality (odds ratio: 2.49; 95% confidence interval: 1.11\u20135.60; p\u2009=\u20090.03).<\/jats:p><jats:p>Incidence of bleeding complications was 40% in the Japanese population. Gastrointestinal tract bleeding emerged as a significant predictor of adverse outcomes, necessitating further research into preventive strategies and optimized care protocols. These findings can guide the management of VV-ECMO patients with COVID-19.<\/jats:p>","DOI":"10.1055\/a-2411-1000","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:28:30Z","timestamp":1725668910000},"page":"308-316","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of Bleeding Complications in Patients with Severe COVID-19 Requiring Veno-venous Extracorporeal Membrane Oxygenation in Japan"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6995-3529","authenticated-orcid":false,"given":"Hayato","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan"},{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeru","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan"},{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichiro","family":"Ohshimo","sequence":"additional","affiliation":[{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Shime","sequence":"additional","affiliation":[{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Kushimoto","sequence":"additional","affiliation":[{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"},{"name":"Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"},{"name":"Non-Profit Organization ICU Collaboration Network (ICON), Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinhiro","family":"Takeda","sequence":"additional","affiliation":[{"name":"Non-profit Organization Japan ECMO Network, Tokyo, Japan"},{"name":"Kawaguchi Cardiovascular and Respiratory Hospital, Kawaguchi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Japan ECMO Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"issue":"9698","key":"ref1","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/S0140-6736(09)61069-2","article-title":"Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial","volume":"374","author":"G J Peek","year":"2009","journal-title":"Lancet"},{"issue":"21","key":"ref2","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1056\/NEJMoa1800385","article-title":"Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome","volume":"378","author":"A Combes","year":"2018","journal-title":"N Engl J 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