{"doi":"10.1111/ejh.14146","title":"Comparison of bleeding and thrombotic outcomes in <scp>veno‐venous extracorporeal membrane oxygenation</scp>: Heparin versus bivalirudin","abstract":"OBJECTIVES: We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO). METHODS: We performed a retrospective cohort study of adult patients placed on V-V ECMO with intravenous anticoagulation with either heparin or bivalirudin. Time to thrombotic event and major bleed were analyzed in addition to related outcomes. RESULTS: We identified 95 patients placed on V-V ECMO: 61 receiving heparin, 34 bivalirudin. The bivalirudin group had a higher rate of severe COVID-19, higher BMI, and longer ECMO duration. Despite this, bivalirudin was associated with reduced risk of thrombotic event (HR 0.14, 95% CI 0.06-0.32, p < .001) and increased average lifespan of the circuit membrane lung (16 vs. 10 days, p = 0.004). While there was no difference in major bleeding, the bivalirudin group required fewer transfusions of packed red blood cells and platelets per 100 ECMO days (means of 13 vs. 39, p = 0.004; 5 vs. 19, p = .014, respectively). Lastly, the bivalirudin group had improved survival to ECMO decannulation in univariate analysis (median OS 53 vs. 26 days, p = .015). CONCLUSIONS: In this real-world analysis of bivalirudin versus heparin, bivalirudin is a viable option for V-V ECMO and associated with lower risk of thrombotic complications and fewer transfusion requirements.","journal":"European Journal Of Haematology","year":2023,"id":345428,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9516,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":302929,"name":"Rick Mathews","orcid":"0000-0003-2723-5646","position":1,"is_corresponding":false},{"id":1085440,"name":"Gina Migneco","orcid":null,"position":2,"is_corresponding":false},{"id":961669,"name":"Taylor Bundy","orcid":null,"position":3,"is_corresponding":false},{"id":278810,"name":"Andy Kaempf","orcid":"0000-0001-9425-6936","position":4,"is_corresponding":false},{"id":1036297,"name":"Michael Pfeffer","orcid":"0000-0002-1758-5442","position":5,"is_corresponding":false},{"id":410071,"name":"Thomas G. DeLoughery","orcid":"0000-0002-5790-4700","position":6,"is_corresponding":false},{"id":1084939,"name":"Kerry Moore","orcid":"0000-0001-9109-9058","position":7,"is_corresponding":false},{"id":1085441,"name":"Rachel Beardshear","orcid":null,"position":8,"is_corresponding":false},{"id":1084940,"name":"Heath J. Oetken","orcid":"0000-0003-0078-7264","position":9,"is_corresponding":false},{"id":1084941,"name":"Jonathan L. Case","orcid":"0000-0002-0846-5836","position":10,"is_corresponding":false},{"id":274862,"name":"Monica T. Hinds","orcid":"0000-0002-5267-3376","position":11,"is_corresponding":false},{"id":293123,"name":"Owen J. T. McCarty","orcid":"0000-0001-9481-0124","position":12,"is_corresponding":false},{"id":339124,"name":"Joseph J. Shatzel","orcid":"0000-0001-9396-5976","position":13,"is_corresponding":false},{"id":68469,"name":"David Zonies","orcid":"0000-0002-8411-6187","position":14,"is_corresponding":false},{"id":926689,"name":"Bishoy Zakhary","orcid":"0000-0002-8662-5911","position":15,"is_corresponding":false},{"id":958439,"name":"Thomas Kartika","orcid":"0000-0003-3926-7127","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T01:11:39.484741Z","pmid":"38088062","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}