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

Autor: 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., Wallisch WJ 4th; Department of Anesthesiology, University of Kansas Hospital, Kansas City, Kansas, USA., Ryan J; Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA., Sanchez P; Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA., Sciortino C; Department of Cardiothoracic Surgery, UPMC, Pittsburgh, PA, USA., Murray H; Cardiothoracic Intensive Care Unit, Department of Critical Care Medicine, UPMC Presbyterian University Hospital, UPMC, Pittsburgh, PA, USA., Arlia P; Department of Perfusion Medicine, UPMC, Pittsburgh, PA, USA., D'Cunha J; Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, USA., Mahajan A; Department of Anesthesiology and Perioperative Medicine, UPMC, Pittsburgh, PA, USA., Triulzi D; Division of Transfusion Medicine, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Subramaniam K; Department of Anesthesiology and Perioperative Medicine, UPMC, Pittsburgh, PA, USA.
Jazyk: angličtina
Zdroj: Vox sanguinis [Vox Sang] 2021 Apr; Vol. 116 (4), pp. 440-450. Date of Electronic Publication: 2020 Nov 20.
DOI: 10.1111/vox.13016
Abstrakt: 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: 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: 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: Platelet transfusion was associated with increased 90-day and 1-year mortality for patients requiring VA-ECMO.
(© 2020 International Society of Blood Transfusion.)
Databáze: MEDLINE
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