Incidence of Platelet Dysfunction by Thromboelastography-Platelet Mapping in Children Supported with ECMO: A Pilot Retrospective Study

Frontiers in Pediatrics
Arun SainiPhilip C Spinella

Abstract

Bleeding complications are common and decrease the odds of survival in children supported with extracorporeal membrane oxygenation (ECMO). The role of platelet dysfunction on ECMO-induced coagulopathy and resultant bleeding complications is not well understood. The primary objective of this pilot study was to determine the incidence and magnitude of platelet dysfunction according to thromboelastography (TEG(®))-platelet mapping (PM) testing. Retrospective chart review of children <18 years old who required ECMO at a tertiary level hospital. We collected TEG(®)-PM and conventional coagulation tests data. We also collected demographic, medications, blood products administered, and clinical outcome data. We defined severe platelet dysfunction as <50% aggregation in response to an agonist. We identified 24 out of 46 children on ECMO, who had TEG(®)-PM performed during the study period. We found the incidence of severe bleeding was 42% and mortality was 54% in our study cohort. In all samples measured, severe qualitative platelet dysfunction was more common for adenosine diphosphate (ADP)-mediated aggregation (92%) compared to arachidonic acid (AA)-mediated aggregation (75%) (p = 0.001). Also, ADP-mediated percent of platelet aggreg...Continue Reading

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Citations

Dec 21, 2018·Expert Review of Hematology·Paolo GreseleEmanuela Falcinelli
Nov 10, 2018·Frontiers in Medicine·Cornelia Heleen Van OmmenMeera B Chitlur
Apr 29, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Elizabeth W J KerrisYaser Diab
Oct 2, 2019·Frontiers in Pediatrics·Katherine CashenHeidi Dalton
Jul 6, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Pilar Anton-MartinCindy Darnell-Bowens
Jun 29, 2021·Frontiers in Cardiovascular Medicine·John C LinPhilip C Spinella

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