Decreasing transfusion exposure risk during extracorporeal membrane oxygenation (ECMO)

H. Scott Bjerke, R. E. Kelly, R. P. Foglia, L. Barcliff, L. Petz

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

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 109/1, 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 Decreases in blood withdrawn (11%) and transfusion volume (7%) were coincident with a 15% reduction in mean bypass time.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%.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalTransfusion Medicine
Volume2
Issue number1
DOIs
StatePublished - Mar 1992

Keywords

  • ECMO
  • extracorporeal
  • neonate
  • packed red blood cells
  • platelet
  • transfusion

ASJC Scopus subject areas

  • Hematology

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