Patient selection: adult on ECMO (venoarterial or venovenous)
Median duration of ECMO: 5 days
Longest duration: 15 days
The lowest values for hemoglobin concentration and platelet count tended to occur on the third day of ECMO.
The protocol indicated that the hemoglobin concentration should be >= 10 g/dL and the platelet count >= 100,000 per µL.
Predictors of red blood cell transfusion:
(1) low nadir hemoglobin concentration (< 7.5 g/dL)
Predictors of fresh frozen plasma (FFP) transfusion:
(1) low nadir hemoglobin concentration (< 7.5 g/dL)
(2) hypertension
Predictors of cryoprecipitate transfusion:
(1) massive transfusion protocol and low fibrinogen
Predictors of platelet transfusion:
(1) recent antiplatelet therapy
(2) larger decline in hemoglobin concentration (> 5.5 g/dL)
(3) longer ECMO duration
Predictors of long ECMO duration and total transfusion requirements:
(1) sepsis
(2) medical (non-surgical)
where:
• Massive transfusion would increase the need for all blood usage but appears to have been uncommon in the study population. On page 39 it was stated that cryoprecipitate was seldom used.
