Increased blood transfusion and its impact in patients having tracheostomy while on extracorporeal membrane oxygenation

Dwight D. Harris, Alexis E. Shafii, Maher Baz, Thomas A. Tribble, Victor A. Ferraris

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Introduction: Tracheostomy has been utilized in combination with venovenous extracorporeal membrane oxygenation (VV-ECMO) to enable early spontaneous breathing and minimize sedation requirements. Tracheostomy has been previously reported to be safe in patients supported on VV-ECMO; however, the impact of tracheostomy on blood loss in VV-ECMO patients is unknown. Methods: We analyzed VV-ECMO patients with and without tracheostomy over a 5-year period. In order to avoid other potential sources of blood loss not related to tracheostomy or ECMO-related blood loss, patients who underwent a recent surgery prior to ECMO or during ECMO (other than tracheostomy) were excluded. Results: Sixty-three patients meeting the inclusion criteria were identified (tracheostomy n=30, non-tracheostomy n=33). Tracheostomy patients were found to require more daily transfusions of red blood cells (RBC) (0.47 [0.20-1.0] vs. 0.23 [0.06-0.40] units/day, p=0.02) and total blood products (0.60 [0.32-1.0] vs. 0.31 [0.10-0.50] units/day, p=0.01). Conclusions: These results suggest that tracheostomy while on VV-ECMO predisposes patients to increased transfusion burden. Based on previous research, this increased transfusion burden could potentially be linked to increased complications and mortality.

Original languageEnglish
Pages (from-to)143-146
Number of pages4
JournalPerfusion (United Kingdom)
Volume34
Issue number2
DOIs
StatePublished - Mar 1 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2018.

Keywords

  • ECMO
  • blood loss
  • blood transfusion
  • extracorporeal membrane oxygenation
  • tracheostomy
  • transfusions
  • venovenous

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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