The Efficiency and Safety of Bivalirudin versus Heparin in The Anticoagulation Therapy in Extracorporeal Membrane Oxygenation: A Meta-Analysis [post]

Min Ma, Shichu Liang, Jingbo Zhu, Yong He
2021 unpublished
Background: Bivalirudin is a direct thrombin inhibitor (DTI), which can be the alternative of unfractionated heparin (UFH). The efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in Extracorporeal membrane oxygenation(ECMO) remains unclear. The purpose of the meta-analysis is to evaluate the efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in ECMO.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were
more » ... ses (PRISMA) were followed. A systematic literature search for original studies was performed in PubMed, EMBASE and The Cochrane Library to identify all relevant studies published prior to January 13,2021. Studies were reviewed according to eligibility and exclusion criteria. The meta-analysis was used to estimate the efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in extracorporeal membrane oxygenation. Results: 6 retrospective studies with 254 patients were eventually included for the quantitative analysis. The results showed that the incidence of major bleeding(I2=66%, P=0.16, OR=0.43, 95%CI:0.13-1.40), thrombosis(I2=0%, P=0.09<0.1, OR=0.56, 95%CI:0.29-1.09) and 30-day mortality(I2=0%, P=0.50, OR=0.90, 95%CI:0.42-1.53) was not statistically significant between the bivalirudin group and the UFH group.Conclusions:This study suggests that bivalirudin and UFH are associated with similar rates of major bleeding, thrombosis and 30-day mortality in adult and pediatric ECMO support, which is safe, practicable, dependable, and cost-effective in comparison with UFH. Bivalirudin is non-inferior to UFH in the anticoagulation therapy in ECMO.
doi:10.21203/rs.3.rs-179603/v1 fatcat:ffuqxa7x6jfibb327qcagzrexa