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Decreasing transfusion exposure risk during extracorporeal membrane oxygenation (ECMO)
Author(s) -
Scott Bjerke H.,
Kelly R. E.,
Foglia R. P.,
Barcliff L.,
Petz L.
Publication year - 1992
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.1992.tb00133.x
Subject(s) - extracorporeal membrane oxygenation , medicine , extracorporeal , intensive care medicine , anesthesia , surgery
SUMMARY. Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy for neonatal pulmonary hypertension but carries a significant risk for transfusion‐related complications. Packed red blood cell (PRBC) and platelet exposure were quantified and reviewed in 17 ECMO survivors prior (Group I, n = 9) and subsequent to (Group II, n = 8) changes in transfusion protocols. Blood product requirements included ECMO circuit priming, maintenance of haematocrit >0.40 or platelet count > 50 times 10 9 /1, and colloid volume expansion. Group I was exposed to 13.8±10.2 ( x ±SD) different PRBC units. In Group II, multiple transfusions from single donor units decreased exposure 71% to 3.9±0.7 units ( P <0.05). Decreases in blood withdrawn (11%) and transfusion volume (7%) were coincident with a 15% reduction in mean bypass time. Platelet volume transfusion decreased from 159±213 to 93±64 ml using volume‐reduced platelet packs. Total transfusion exposure decreased 59% from 20.8±17.8 units to 8.6±2.4 donor units. No transfusion complications occurred during the aggregate 1,926 h on bypass. We conclude that neonates on ECMO have a significant transfusion exposure risk increasing with prolonged duration of ECMO therapy. In addition we noted that concentrated platelet packs decreased transfusion volume by 41%, and multiple PRBC transfusions from single donor units decreased donor exposure by 71% while both strategies decreased the overall transfusion exposure risk by 59%.