A retrospective study to assess the transfusion requirements of patients on extracorporeal membrane oxygenation support.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) is a mode of therapy initiated for patients with cardiac and/or respiratory failure. Blood transfusion plays a significant role in the management of ECMO patients. In this study, pediatric patients were all cyanotic and transfusion requirements of cyanotic patients differ from other critically ill patients. This study has been conducted to assess the daily transfusion requirements of such group of patients to frame future transfusion policies.

Aims and objectives: This study was undertaken to assess the daily transfusion requirements of ECMO patients with various indications for ECMO initiation. Our aim was to formulate institutional transfusion policies for paediatric and adult patients on ECMO.

Materials and methods: A three years retrospectivTable study was undertaken with 20 study participants. Transfusion requirements were analyzed with regard to the number of days on ECMO support and indications for ECMO initiation. Iatrogenic blood loss/day was assessed among paediatric age group.

Results: Maximum transfusions with PRBC, FFP, and platelet concentrates occurred during the initial 7 days on ECMO. The median packed red cell requirement and FFP requirements for pediatric age group was 1260 ml (IQR = 360-3580) and 900 ml (IQR=150-4650) ml respectively. The median platelet and cryoprecipitate requirements were 450 ml (80-1610) and 120 ml (0.00-600) respectively. The median survival was 8 days (IQR=5.961-10.039).

Conclusion: Transfusion requirements would largely depend upon the clinical status of the patient and therefore, with a smaller number of participants it is difficult to make generalised recommendations. However, the present study could help us to frame institutional-based transfusion support policies for ECMO patients.