Abstract Number: PB0485
Meeting: ISTH 2020 Congress
Background: Bleeding, thrombocytopenia and platelet dysfunction occur frequently with Extracorporeal Membrane Oxygenation (ECMO). However, there is limited data on prevalence, indication and outcomes in patients receiving platelet transfusions during ECMO.
Aims: To review the outcomes of patients requiring platelet transfusions during ECMO.
Methods: A single centre retrospective analysis of patients receiving veno-venous ECMO between 01/01/2011 and 31/12/2017 was performed using electronic patient data software. Platelets were transfused at clinician discretion during bleeding and to maintain a platelet count > 50×109/L. Platelet transfusion prescriptions, clinical outcomes were obtained. Data was analysed using R software with Chi-squared and Wilcoxon rank tests.
Results: Over a 7-year period, 402 patients received ECMO with a total of 1348 platelet transfusions given. 225 [56%] of patients did not receive platelet transfusion and 177 [44%] received at least one unit, giving a mean of 0.2 platelet transfusions/patient/day of ECMO. The incidence of transfusion reduced linearly over the first 28 days with a slope of -0.013 platelet transfusions/patient/day (95% CI: -0.011, -0.016). Patients who received platelets were older (47 vs 43 years, p< 0.05), with higher APACHE II scores (19 vs 17, p< 0.05) and longer duration of ECMO support (10 vs 7 days, p< 0.05). Survival to decannulation (200/225 [89%] vs 128/177 [72%], p< 0.05) and discharge from intensive care was lower in those receiving platelet transfusions. 712 [53%] of platelet transfusions were given to those with a preceding platelet count < 50x109/L. 83 of 177 patients [47%] received platelet transfusions in the context of a major haemorrhage (>/=4 units red cells unit in 24 hours).
Conclusions: Platelet transfusions were administered to patients with greater critical illness severity and with an increased short-term mortality rate. There was heterogeneity in the transfusion thresholds due to a mixture of asymptomatic patients and those with significant bleeding.
To cite this abstract in AMA style:Doyle A, Sanderson B, Vasques F, Wyncoll D, Barrett NA, Hunt BJ, Camporota L, Retter A. The Use of Platelet Transfusions during Extracorporeal Membrane Oxygenation in a Large Tertiary Centre [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-use-of-platelet-transfusions-during-extracorporeal-membrane-oxygenation-in-a-large-tertiary-centre/. Accessed October 1, 2023.
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