A patient on Extracorporeal Membrane Oxygenation (ECMO) therapy may be transfused for a number of reasons. The prognosis for the patient tends to worsen as the adjusted tranfusion volume increases.
Patient selection: ECMO
Parameters:
(1) duration of ECMO therapy in days
(2) body weight of the patient in kilograms
(3) total volume of blood transfused during ECMO in mL
(4) volume of blood used to prime the ECMO unit in mL
transfused volume =
= (total blood transfused) - (blood volume to prime the unit)
adjusted blood volume in mL per kg per day of ECMO therapy=
Muszynski et al found that for pediatric patients each additional increase in 10 mL/kg/day was associated with a 9% increase for in-hospital mortality.
Smith et al found that for patients on ECMO each 10 mL/kg/day of blood transfusion was associated with a 24% increase in the odds of in-hospital mortality.
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