• M J Santiago, C Gómez, I Magaña, V Muñoz, P Saiz, A Sánchez, and J López-Herce.
• Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria, Hospital Gregorio Marañón, Madrid, España; Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RD16/0022/0007, Madrid RETICS financiada por el PN I+D+I 2008-2011, ISCIII, Subdirección General de Evaluación y Fomento de la Investigación y el Fondo Europeo de Desarrollo Regional (FEDER), ef. RD16/0022/0007.
• Med Intensiva. 2019 Jun 1; 43 (5): 281-289.

ObjectivesTo analyze the hematological complications and need for transfusions in children receiving extracorporeal life support (ECLS).DesignA retrospective study was carried out.SettingA pediatric intensive care unit.PatientsChildren under 18 years of age subjected to ECLS between September 2006 and November 2015.InterventionsNone.Variables Of InterestPatient and ECLS characteristics, anticoagulation, hematological and coagulation parameters, transfusions and clinical course.ResultsA total of 100 patients (94 with heart disease) with a median age of 11 months were studied. Seventy-six patients presented bleeding. The most frequent bleeding point was the mediastinum and 39 patients required revision surgery. In the first 3days, 97% of the patients required blood transfusion (34.4ml/kg per day), 94% platelets (21.1ml/kg per day) and 90% plasma (26.6ml/kg per day). Patients who were in the postoperative period, those who were bleeding at the start of ECLS, those requiring revision surgery, those who could not suspend extracorporeal circulation, and those subjected to transthoracic cannulation required a greater volume of transfusions than the rest of the patients. Thromboembolism occurred in 14 patients and hemolysis in 33 patients. Mortality among the children who were bleeding at the start of ECLS (57.6%) was significantly higher than in the rest of the patients (37.5%) (P=.048).ConclusionsChildren subjected to ECLS present high blood product needs. The main factors related to transfusions were the postoperative period, bleeding at the start of ECLS, revision surgery, transthoracic cannulation, and the impossibility of suspending extracorporeal circulation. Children with bleeding suffered greater mortality than the rest of the patients.Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

30 keywords...

hide…