Restrictive Transfusion Practice During Extracorporeal Membrane Oxygenation Therapy for Severe Acute Respiratory Distress Syndrome

• DOI: 10.1111/aor.12385
• Publication Date: 2014-10-28T04:25:12Z
• Authors: Maria T. Voelker; Thilo Busch; Sven Bercker; Falk Fichtner; Udo X. Kaisers; Sven Laudi
• Keywords: Adult; Male; Respiratory Distress Syndrome; Time Factors; Adolescent; Critical Illness; Middle Aged; Severe Acute Respiratory Syndrome; 3. Good health; Hemoglobins; 03 medical and health sciences; Extracorporeal Membrane Oxygenation; 0302 clinical medicine; Hematocrit; Predictive Value of Tests; Risk Factors; Humans; Female; Hospital Mortality; Lactic Acid; Erythrocyte Transfusion; Biomarkers; Retrospective Studies

Recommendations concerning the management of hemoglobin levels and hematocrit in patients on extracorporeal membrane oxygenation (ECMO) still advise maintenance a normal hematocrit. In contrast, current transfusion guidelines for critically ill support restrictive practice. We report series receiving venovenous ECMO (vvECMO) acute respiratory distress syndrome (ARDS) treated according to regimen recommended patients. retrospectively analyzed 18 vvECMO due severe ARDS. Hemoglobin concentrations were kept between 7 9 g/dL with trigger at or when physiological triggers apparent. assessed baseline data, hospital mortality, time ECMO, levels, hematocrit, quantities packed red blood cells received, lactate compared survivors nonsurvivors. The overall mortality all was 38.9%. Mean concentration over days 8.30 ± 0.51 g/dL, 0.25 0.01, no difference numbers given PRBCs showed trend towards higher group nonsurvivors, but not significant (1.97 1.47 vs. 0.96 0.76 units; P = 0.07). clearance from first third day 45.4 28.3%, nonsurvivors (P 0.19). our cohort ARDS, application protocol did result an increased mortality. Safety feasibility must further be evaluated randomized controlled trials.