Henríquez-Henríquez Marcela, Kattan Javier, Chang Mayling, Pizarro Isabel, Faunes Miriam, Martinez Claudia, Gonzalez Alvaro, Pereira Jaime
1 Departments of Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Santiago - Chile.
Int J Artif Organs. 2014 Mar;37(3):233-40. doi: 10.5301/ijao.5000311. Epub 2014 Apr 4.
BACKGROUND/AIMS: Hemorrhagic complications during ECMO may affect a large proportion of the patients depending on the clinical setting. To guarantee optimal delivery of blood products to these patients, blood banks require updated information on the transfusion requirements. Few studies to date provide this information. This work assesses transfusion requirements in neonates and children during ECMO during the past 9 years.
We reviewed blood bank and hospital records of patients who underwent ECMO at our institution between May 2003 and May 2012. Data obtained included age, weight, diagnosis, type, length of ECMO, and daily transfusion requirements during ECMO. Descriptive and non-parametric inferential statistic analyses were performed. Our series included 98 patients.
Mean time of patients on ECMO was 9.2 days, with the longest treatment spanning 22 days. Mean daily transfusion requirements were 39.5 ml/kg of RBC, 12.9 ml/kg of plasma, 34.3 ml/kg of platelets and 1.4 ml/kg of cryoprecipitate. Patients who underwent ECMO due to cardiac disease or congenital diaphragmatic hernia (CDH) required significantly higher transfusion volumes of plasma (p<0.05), platelets (p< 0.05) and cryoprecipitate (p<0.05) when compared to patients underwent ECMO due to respiratory disease. Concomitant with the aging of ECMO circuits, patients showed increased requirements of RBC, plasma, and CRYO around the seventh day of the ECMO run. This effect was not observed for platelets, which remained nearly consistent around 2.2 transfusions/day.
ECMO patients required significant transfusion support, which was particularly higher among patients who underwent ECMO due to cardiac disease or congenital diaphragmatic hernia.
背景/目的：体外膜肺氧合（ECMO）期间的出血并发症可能会根据临床情况影响很大一部分患者。为了确保向这些患者最佳地输送血液制品，血库需要有关输血需求的最新信息。迄今为止，很少有研究提供此类信息。本研究评估了过去9年中新生儿和儿童在ECMO期间的输血需求。
我们回顾了2003年5月至2012年5月在我院接受ECMO治疗的患者的血库和医院记录。获得的数据包括年龄、体重、诊断、ECMO类型、时长以及ECMO期间的每日输血需求。进行了描述性和非参数推断统计分析。我们的系列研究包括98例患者。
患者接受ECMO的平均时长为9.2天，最长治疗时间为22天。每日平均输血需求量为：红细胞39.5毫升/千克、血浆12.9毫升/千克、血小板34.3毫升/千克和冷沉淀1.4毫升/千克。与因呼吸系统疾病接受ECMO治疗的患者相比，因心脏病或先天性膈疝（CDH）接受ECMO治疗的患者对血浆（p<0.05）、血小板（p<0.05）和冷沉淀（p<0.05）的输血量需求显著更高。随着ECMO回路的老化，患者在ECMO运行约第七天时对红细胞、血浆和冷沉淀的需求增加。血小板未观察到这种影响，其每日输血次数保持在2.2次左右基本稳定。
ECMO患者需要大量输血支持，这在因心脏病或先天性膈疝接受ECMO治疗的患者中尤为明显。
