PB0092 - D-dimer kinetic variations on STA-R Max® and sthemO® instruments to predict bleeding complications in ECMO.

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Co-Author(s)

MB

Matthieu Bourdin

Team Leader
R&D - Diagnostica Stago
Gennevilliers, Ile-de-France, France
AM

Audrey Molet

Associate scientist
R&D - Diagnostica Stago
Gennevilliers, Ile-de-France, France
SC

Sidy Mouhamed Casse

Data Analyst
R&D - Diagnostica Stago
Gennevilliers, Ile-de-France, France
GC

Geneviève Contant

Prospective Research Director
R&D - Diagnostica Stago
Gennevilliers, Ile-de-France, France

Presenting Author(s)

François DEPASSE

Director
Clinical Development - Diagnostica Stago
Asnières sur Seine, Ile-de-France, France

Co-Author(s)

JH

Julie Helms

Professor
CHRU de Strasbourg
Strasbourg, Alsace, France
EA

Eduardo Angles-cano

Research Director
French Institute of Health and Medical Research (Inserm) - Université Paris Descartes
Paris, Ile-de-France, France
OM

Olivier Mathieu

Manager
R&D - Diagnostica Stago
Gennevilliers, Ile-de-France, France

Background: The dynamic measurement of D-dimer over two days can predict bleeding complications in patients undergoing Extracorporeal Membrane Oxygenation (ECMO) [Helms et al. Intensive Care Med 2023].

Aims: To demonstrate the ability of D-dimer kinetic variations measured on two different instruments to predict hemorrhagic complication in ECMO.

Methods: Thirty patients undergoing ECMO were included in a prospective exploratory cohort. Blood was sampled before ECMO implantation and daily until ablation of ECMO by day 10. Thirty-eight severe hemorrhagic events required transfusions or led to functional or life-threatening bleeding (grade 3-4, WHO classification). The D-dimer kinetic was determined daily using STA-Liatest® D-Di on STA-R Max® and sthemO® D-Di on sthemO 301®. The first derivative was calculated as the difference of D-dimer level between two consecutive days (ΔDn=Dn-D(n-1)). Derivatives were statistically compared between groups (No hemorrhage vs hemorrhage) using Wilcoxon-Mann-Whitney’s test. Odds-ratios (OR) were calculated to determine the strength of association between ΔD and hemorrhage.

Results: The Passing-Bablok analysis between the two instruments yielded a good correlation (data non shown). Interestingly, similar significant derivative increases were observed between the first derivatives of D-Dimer on STA-R Max® (p=0.015) and sthemO 301® (p=0.028). ΔD OR>1µg/mL the day before hemorrhage was 5.53 [1.06;28.93] on STA-R Max® and 5.39 [1.51;19.22] on sthemO 301® demonstrating the ability of D-dimer kinetic variation to identify patients at increased bleeding risk one day before the event.

Conclusion(s): The variations in D-dimer levels obtained on both instruments the day before hemorrhage provide comparable predictions of bleeding in ECMO patients. Our study introduces a methodological approach, suggesting D-dimer increases between two days as a practical automated marker to predict hemorrhagic complications in ECMO.