Comparison of transfusion thresholds during neonatal extracorporeal membrane oxygenation

Transfusion
Alexandra A SawyerBrian K Stansfield

Abstract

The objective of this study was to assess complications and patient outcomes associated with a lower reflexive red blood cell (RBC) transfusion threshold for neonates undergoing extracorporeal membrane oxygenation (ECMO) for hypoxic respiratory failure. A retrospective cohort study was conducted at a single tertiary neonatal intensive care unit of neonates undergoing ECMO support for refractory hypoxic respiratory failure for more than 24 hours between December 2009 and December 2014. Seventy-two neonates received ECMO support for hypoxic respiratory failure for longer than 24 hours during the study period. Patient cohorts were determined based on transfusion threshold of hematocrit (Hct) level of less than 40% (December 2009-October 2012) and Hct level of less than 35% (November 2012-December 2014). Patients who had a lower threshold for transfusion (Hct < 35) had a lower mean Hct (38.3% vs. 41.4%, p < 0.0001) and received less total RBC transfusion volume (10.4 mL/kg/day vs. 13.3 mL/kg/day, p = 0.002) while undergoing ECMO support. Survival off ECMO, survival to discharge, and complication rates were similar between the cohorts. A lower Hct threshold of 35% is associated with a reduction in RBC transfusion volume and does not...Continue Reading

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Mar 9, 2018·Critical Care Medicine·Jennifer A MuszynskiUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Resear
Jun 19, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Conor P O'HalloranRavi R Thiagarajan
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Nov 5, 2019·Clinical Lymphoma, Myeloma & Leukemia·Lindsay Wilde, Jonathan Pan

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