Tauber et al identified predictive factors for high blood transfusion requirements in a patient receiving extracorporeal membrane oxygenation (ECMO) support. The authors are from the Medical University of Innsbruck in Austria.
Patient: adult on ECMO support for cardiac and/or respiratory failure
Endpoint: need for >= 2 units of packed red blood cells per day
Predictors:
(1) serum creatinine concentration at baseline
(2) prothrombin time at baseline in percent (normally 70 to 130%)
(3) impaired platelet function after 24 hours based on multiplate thrombin receptor activating peptide (TRAP) stimulation
Parameter
Finding
Points
serum creatinine
< 1.49 mg/dL
0
>= 1.49 mg/dL
1
prothrombin time
> 48%
0
<= 48%
1
TRAP
> 32 units
0
<= 32 units
1
where:
• The prothrombin time appears to be a measure of prothrombin activity.
• Refer to Table 6 on page 698.
number of risk factors for higher transfusion need =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The need for blood transfusion tends to increase as the number of predictors increase.
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