• Colin G McCloskey and Milo C Engoren.
• University of Michigan Department of Anesthesia, Division of Critical Care, 4172 Cardiovascular Center, 1500 East Medical Center Drive, SPC 5861, Ann Arbor, MI 48109, USA. Electronic address: Colin.McCloskey@UHHospitals.org.
• J Crit Care. 2022 Apr 1; 68: 42-47.

PurposePatients receiving veno-arterial Extracorporeal Membrane Oxygenation (V-A ECMO) may require transfusion due to bleeding risk and desire to optimize oxygen delivery. The purposes of this study were to determine the transfusion requirements in patients receiving V-A ECMO and to determine if transfusion was associated with hospital mortality or complications.Material And MethodsRetrospective chart review of adult patients at University of Michigan between 1/1/2000-6/1/2017. Survivors and decedents were compared. Logistic regression was used to determine factors independently associated with mortality, hemorrhage, and ischemic events.ResultsOne hundred eighty-seven patients received V-A ECMO. Median number of red cells transfused was 9 units (interquartile range 3.5-20), platelets 4 (1-11) packs, plasma 2 (0-6) units, cryoprecipitate 0 (0,0) units. Only 69 (37%) patients survived to hospital discharge. Hemorrhage occurred in 108 (58%) patients and 27 (14%) suffered ischemic complications. Renal replacement therapy (OR 2.94, 95% confidence interval: 1.51-5.68, p < 0.001) and ECMO duration (OR 1.01, 95% confidence interval: 1.00-1.01, p = 0.005) but not transfusion, were associated with increased odds of death.ConclusionMost patients receiving V-A ECMO are transfused multiple units of blood products. Receipt of transfusion or having a bleeding or ischemic complication was not associated with increased mortality.Copyright © 2021 Elsevier Inc. All rights reserved.

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