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The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation:a multicenter observational study
- Source :
- Raasveld , S J , van den Oord , C , Schenk , J , van den Bergh , W M , Oude Lansink - Hartgring , A , van der Velde , F , Maas , J J , van de Berg , P , Lorusso , R , Delnoij , T S R , Dos Reis Miranda , D , Scholten , E , Taccone , F S , Dauwe , D F , De Troy , E , Hermans , G , Pappalardo , F , Fominskiy , E , Ivancan , V , Bojčić , R , de Metz , J , van den Bogaard , B , Donker , D W , Meuwese , C L , De Bakker , M , Reddi , B , Henriques , J P S , Broman , L M , Dongelmans , D A & Vlaar , A P J 2023 , ' The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation : a multicenter observational study ' , Critical Care , vol. 27 , no. 1 , 321 .
- Publication Year :
- 2023
-
Abstract
- Background: Thrombocytopenia, hemorrhage and platelet transfusion are common in patients supported with venoarterial extracorporeal membrane oxygenation (VA ECMO). However, current literature is limited to small single-center experiences with high degrees of heterogeneity. Therefore, we aimed to ascertain in a multicenter study the course and occurrence rate of thrombocytopenia, and to assess the association between thrombocytopenia, hemorrhage and platelet transfusion during VA ECMO. Methods: This was a sub-study of a multicenter (N = 16) study on transfusion practices in patients on VA ECMO, in which a retrospective cohort (Jan-2018–Jul-2019) focusing on platelets was selected. The primary outcome was thrombocytopenia during VA ECMO, defined as mild (100–150·109/L), moderate (50–100·109/L) and severe (< 50·109/L). Secondary outcomes included the occurrence rate of platelet transfusion, and the association between thrombocytopenia, hemorrhage and platelet transfusion, assessed through mixed-effect models.Results: Of the 419 patients included, median platelet count at admission was 179·109/L. During VA ECMO, almost all (N = 398, 95%) patients developed a thrombocytopenia, of which a significant part severe (N = 179, 45%). One or more platelet transfusions were administered in 226 patients (54%), whereas 207 patients (49%) suffered a hemorrhagic event during VA ECMO. In non-bleeding patients, still one in three patients received a platelet transfusion. The strongest association to receive a platelet transfusion was found in the presence of severe thrombocytopenia (adjusted OR 31.8, 95% CI 17.9–56.5). After including an interaction term of hemorrhage and thrombocytopenia, this even increased up to an OR of 110 (95% CI 34–360). Conclusions: Thrombocytopenia has a higher occurrence than is currently recognized. Severe thrombocytopenia is strongl
Details
- Database :
- OAIster
- Journal :
- Raasveld , S J , van den Oord , C , Schenk , J , van den Bergh , W M , Oude Lansink - Hartgring , A , van der Velde , F , Maas , J J , van de Berg , P , Lorusso , R , Delnoij , T S R , Dos Reis Miranda , D , Scholten , E , Taccone , F S , Dauwe , D F , De Troy , E , Hermans , G , Pappalardo , F , Fominskiy , E , Ivancan , V , Bojčić , R , de Metz , J , van den Bogaard , B , Donker , D W , Meuwese , C L , De Bakker , M , Reddi , B , Henriques , J P S , Broman , L M , Dongelmans , D A & Vlaar , A P J 2023 , ' The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation : a multicenter observational study ' , Critical Care , vol. 27 , no. 1 , 321 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1398451843
- Document Type :
- Electronic Resource