Platelet transfusion is associated with 90-day and 1-year mortality for adult patients requiring veno-arterial extracorporeal membrane oxygenation.


Journal

Vox sanguinis
ISSN: 1423-0410
Titre abrégé: Vox Sang
Pays: England
ID NLM: 0413606

Informations de publication

Date de publication:
Apr 2021
Historique:
revised: 18 09 2020
received: 17 06 2020
accepted: 21 09 2020
pubmed: 21 11 2020
medline: 29 6 2021
entrez: 20 11 2020
Statut: ppublish

Résumé

Studies examining one-year mortality respecting component blood transfusion are sparse. We hypothesize that component blood product transfusions are negatively associated with 90-day and 1-year survival for all patients requiring veno-arterial (VA) or veno-venous (VV) ECMO. This was an IRB-approved retrospective cohort analysis of 676 consecutive patients requiring ECMO at the University of Pittsburgh between 2005 and 2016. Patients were analysed both as an entire cohort and as two subsets with respect to ECMO modality (VA vs. VV). Additional data collected and analysed included patient characteristics, laboratory values and blood product transfusion. Multivariable analysis revealed that platelet transfusion was associated with 90-day mortality (OR: 1·05, P = 0·037) and one-year mortality for the entire cohort (OR = 1·05, P = 0·046,). Platelet transfusion volume was also associated with mortality in the VA-ECMO subset of patients at both 90 days (OR = 1·08, P = 0·03) and one year (OR: 1·11, P = 0·014). Age, peak International Normalized Raton ECMO, nadir haemoglobin (on ECMO) and final haemoglobin (after ECMO) were significantly associated with mortality for patients requiring VA-ECMO. For VV-ECMO patients, age, INR and peak creatinine on ECMO were associated with mortality. No individual component blood product was associated with one-year mortality for patients requiring VV-ECMO. Platelet transfusion was associated with increased 90-day and 1-year mortality for patients requiring VA-ECMO.

Sections du résumé

BACKGROUND BACKGROUND
Studies examining one-year mortality respecting component blood transfusion are sparse. We hypothesize that component blood product transfusions are negatively associated with 90-day and 1-year survival for all patients requiring veno-arterial (VA) or veno-venous (VV) ECMO.
STUDY DESIGN AND METHODS METHODS
This was an IRB-approved retrospective cohort analysis of 676 consecutive patients requiring ECMO at the University of Pittsburgh between 2005 and 2016. Patients were analysed both as an entire cohort and as two subsets with respect to ECMO modality (VA vs. VV). Additional data collected and analysed included patient characteristics, laboratory values and blood product transfusion.
RESULTS RESULTS
Multivariable analysis revealed that platelet transfusion was associated with 90-day mortality (OR: 1·05, P = 0·037) and one-year mortality for the entire cohort (OR = 1·05, P = 0·046,). Platelet transfusion volume was also associated with mortality in the VA-ECMO subset of patients at both 90 days (OR = 1·08, P = 0·03) and one year (OR: 1·11, P = 0·014). Age, peak International Normalized Raton ECMO, nadir haemoglobin (on ECMO) and final haemoglobin (after ECMO) were significantly associated with mortality for patients requiring VA-ECMO. For VV-ECMO patients, age, INR and peak creatinine on ECMO were associated with mortality. No individual component blood product was associated with one-year mortality for patients requiring VV-ECMO.
CONCLUSION CONCLUSIONS
Platelet transfusion was associated with increased 90-day and 1-year mortality for patients requiring VA-ECMO.

Identifiants

pubmed: 33215723
doi: 10.1111/vox.13016
doi:

Substances chimiques

Hemoglobins 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

440-450

Informations de copyright

© 2020 International Society of Blood Transfusion.

Références

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Auteurs

Stephen A Esper (SA)

Cardiovascular and Thoracic Division, Director, Department of Anesthesiology and Perioperative Medicine, UPMC Center for Perioperative Care, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA.

William John Wallisch (WJ)

Department of Anesthesiology, University of Kansas Hospital, Kansas City, Kansas, USA.

John Ryan (J)

Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA.

Pablo Sanchez (P)

Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA.

Christopher Sciortino (C)

Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA.

Holt Murray (H)

Cardiothoracic Intensive Care Unit, Department of Critical Care Medicine, UPMC Presbyterian University Hospital, UPMC, Pittsburgh, PA, USA.

Peter Arlia (P)

Department of Perfusion Medicine, UPMC, Pittsburgh, PA, USA.

Jonathan D'Cunha (J)

Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, USA.

Aman Mahajan (A)

Department of Anesthesiology and Perioperative Medicine, UPMC, Pittsburgh, PA, USA.

Darrell Triulzi (D)

Division of Transfusion Medicine, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Kathirvel Subramaniam (K)

Department of Anesthesiology and Perioperative Medicine, UPMC, Pittsburgh, PA, USA.

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