Understanding the Outcomes of Extracorporeal Membrane Oxygen Support in Patients With Sickle Cell Trait.

Abstract

The impact of common hemoglobinopathies, such as sickle cell trait (SCT), on outcomes in adults requiring extracorporeal membrane oxygenation (ECMO) remains understudied. Extracorporeal Life Support Organization registry data was analyzed to assess outcomes of adults with SCT or sickle cell disease (SCD) who underwent venoarterial or venovenous ECMO. Among 215 patients identified, 49 had SCT and 166 had SCD. The prevalence of SCT appeared grossly underestimated. Age-adjusted survival rates for SCT patients were favorable compared with those with SCD for venoarterial (43.5% vs. 19.5%; p = 0.04) and venovenous (73.3% vs. 44.8%; p = 0.11) ECMO. Bleeding and thrombotic event rates and renal complications in SCT patients were comparable to those with SCD and similar to reported rates in general adult ECMO populations. While our findings suggest that ECMO may be safely used in patients with SCT, further investigation is essential to determine the clinical impact of sickle cell and other hemoglobinopathies on ECMO therapy.