BLOOD UTILIZATION IN ADULT PATIENTS UNDERGOING EXTRACORPOREAL MEMBRANE-OXYGENATION THERAPY

Background: The impact of extracorporeal membrane oxygenation (ECMO), performed on adult patients, on the blood transfusion service of a ter tiary-care hospital was assessed. The quantity and pattern of blood co mponent utilization by these patients were compared to those in a prev ious evaluation of neonatal patients receiving similar treatment. Stud y Design and Methods: The records of blood component transfusion to 74 adult patients, treated with ECMO within a 6-year period, were review ed. This information was correlated with the clinical indication for E CMO and duration of ECMO treatment. In addition, daily use of componen ts for these patients was studied to ascertain whether the blood requi rements were predictable and uniform. Results: Over 15,000 units of bl ood components, with platelet concentrates making up the largest porti on, were transfused to these patients while they were undergoing ECMO. The duration of ECMO varied from less than 1 day to 53 days. However, the length of treatment could not uniformly be correlated with blood utilization or with survival. Daily blood transfusion needs often coul d not be anticipated, which meant that the transfusion service frequen tly had to respond to urgent requests for transfusion support. The pro vision of platelet concentrates proved to be the most difficult part o f the maintenance of this program. Conclusion: Whereas ECMO treatment of neonatal patients has a relatively minor impact on a transfusion se rvice, the same is not true for a program that uses this form of treat ment for adults as well.