Abstract：
PURPOSE:Extracorporeal life support (ECLS) is used for patients with refractory heart failure with or without respiratory failure. This temporary support is provided by blood pumps which are connected to large vessels. Bleeding episodes are a typical complication in patients with ECLS. Recently, several studies illustrated that acquired von Willebrand syndrome (AVWS) can contribute to bleeding tendencies in patients with long-term ventricular assist devices (VAD). AVWS is characterized by loss of the high molecular weight (HMW) multimers of von Willebrand factor (VWF) as a result of high shear stress and leads to impaired binding of VWF to platelets and to subendothelial matrix. Since ECLS and VAD share several features, we investigated patients with ECLS for AVWS. METHODS:We analyzed 32 patients with ECLS and 19 of them without support. To diagnose AVWS, ratios of ristocetin cofactor activity (VWF:RCo) and collagen binding capacity (VWF:CB) to VWF antigen (VWF:Ag) were employed in conjunction with multimeric analysis. RESULTS:Reduced VWF:RCo/VWF:Ag ratios were identified in 28 ECLS patients. Furthermore, VWF:CB/VWF:Ag ratios were decreased in 31 patients. HMW multimers of VWF were missing in the same 31 patients. Thus, 31 of 32 ECLS patients presented with AVWS. Twenty-two of the 32 patients suffered from bleeding complications. Without support, AVWS was not detectable in any analyzed patient. CONCLUSION:Our data indicate that AVWS is a typical disorder in patients with ECLS. We hypothesize that AVWS could contribute to aggravation of bleeding tendencies in ECLS patients.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Heilmann C,Geisen U,Beyersdorf F,Nakamura L,Benk C,Trummer G,Berchtold-Herz M,Schlensak C,Zieger Bdoi
10.1007/s00134-011-2370-6subject
Has Abstractpub_date
2012-01-01 00:00:00pages
62-8issue
1eissn
0342-4642issn
1432-1238journal_volume
38pub_type
杂志文章abstract：PURPOSE:The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients wit...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s00134-013-3145-z
更新日期：2014-02-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
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更新日期：1993-01-01 00:00:00
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journal_title：Intensive care medicine
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更新日期：2009-03-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340101061
更新日期：2001-10-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2565-5
更新日期：2012-07-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章,评审
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更新日期：1981-01-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章,评审
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journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-006-0459-0
更新日期：2007-02-01 00:00:00
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pub_type： 杂志文章
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pub_type： 杂志文章
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更新日期：2005-11-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章,评审
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更新日期：2014-06-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s001340101107
更新日期：2001-11-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
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更新日期：1990-01-01 00:00:00
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pub_type： 杂志文章
doi：10.1007/BF01641120
更新日期：1977-12-01 00:00:00
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doi：10.1007/s00134-011-2296-z
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pub_type： 信件
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更新日期：2018-06-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1664-8
更新日期：2003-04-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051090
更新日期：1999-12-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01058568
更新日期：1989-01-01 00:00:00
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journal_title：Intensive care medicine
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doi：10.1007/s001340050629
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journal_title：Intensive care medicine
pub_type： 杂志文章,评审
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更新日期：2011-03-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
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更新日期：2010-02-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
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更新日期：2000-03-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
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更新日期：2020-06-01 00:00:00
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journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01713935
更新日期：1991-01-01 00:00:00
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pub_type： 杂志文章
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更新日期：2000-05-01 00:00:00
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pub_type： 杂志文章,多中心研究
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更新日期：2006-01-01 00:00:00
