The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation: a multicenter observational study
Authors' conclusion
Thrombocytopenia has a higher occurrence than is currently recognized. Severe thrombocytopenia is strongly associated with platelet transfusion.
Study context
- Population
- Patients supported with VA ECMO, 16 centres, Jan-2018-Jul-2019
- Participants
- 419 patients · 16 centres
- Outcome
- Thrombocytopenia during VA ECMO: mild (100-150.109/L), moderate (50-100.109/L), severe (< 50.109/L)
Methodological detailsmulticentre, sub-study of a multicentre study on transfusion practices
- Multicentre
- Sub-study of a multicentre study on transfusion practices
Main finding
As reported in the abstract
Thrombocytopenia during VA ECMO
Any thrombocytopenia, N = 398
95%
Severe thrombocytopenia, N = 179
45%
Median platelet count at admission
179.109/L
Observational data: associations, not effects.
Secondary outcomes
Association of severe thrombocytopenia with platelet transfusion (mixed-effect models)
| Estimate | ||
|---|---|---|
| Severe thrombocytopenia | aOR 31.8 (95% CI 17.9–56.5) | |
| Severe thrombocytopeniaWith interaction term of hemorrhage and thrombocytopenia | OR 110 (95% CI 34–360) | |
| 0.050.21520Ratio (log scale) |
Platelet transfusion and hemorrhage
- ≥1 platelet transfusion, 226 patients
- 54%
- Hemorrhagic event, 207 patients
- 49%
- Non-bleeding patients receiving a platelet transfusion
- one in three
Original publication
The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation: a multicenter observational study. Crit Care. Published 21 August 2023. doi:10.
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