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Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial.

Publication ,  Journal Article
McMichael, ABV; Zimmerman, KO; Kumar, KR; Ozment, CP
Published in: Transfusion
January 2021

BACKGROUND: Factor consumption is common during ECMO complicating the balance of pro and anticoagulation factors. This study sought to determine whether transfusion of coagulation factors using fresh frozen plasma (FFP) increased ECMO circuit life and decreased blood product transfusion. Secondly, it analyzed the association between FFP transfusion and hemorrhagic and thrombotic complications. STUDY DESIGN AND METHODS: Thirty-one pediatric ECMO patients between October 2013 and January 2016 at a quaternary care institution were included. Patients were randomized to FFP every 48 hours or usual care. The primary outcome was ECMO circuit change. Secondary outcomes included blood product transfusion, survival to decannulation, hemorrhagic and thrombotic complications, and ECMO costs. RESULTS: Median (interquartile range [IQR]) number of circuit changes was 0 (0, 1). No difference was seen in percent days without a circuit change between intervention and control group, P = .53. Intervention group patients received median platelets of 15.5 mL/kg/d IQR (3.7, 26.8) vs 24.8 mL/kg/d (12.2, 30.8) for the control group (P = .16), and median packed red blood cells (pRBC) of 7.7 mL/kg/d (3.3, 16.3) vs 5.9 mL/kg/d (3.4, 18.7) for the control group, P = .60. FFP transfusions were similar with 10.2 mL/kg/d (5.0, 13.9) in the intervention group vs 8.8 (2.5, 17.7) for the control group, P = .98. CONCLUSION: In this pilot randomized study, scheduled FFP did not increase circuit life. There was no difference in blood product transfusion of platelets, pRBCs, and FFP between groups. Further studies are needed to examine the association of scheduled FFP with blood product transfusion.

Duke Scholars

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

January 2021

Volume

61

Issue

1

Start / End Page

42 / 51

Location

United States

Related Subject Headings

  • Thrombosis
  • Retrospective Studies
  • Plasma
  • Pilot Projects
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Hemorrhage
  • Female
 

Citation

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McMichael, A. B. V., Zimmerman, K. O., Kumar, K. R., & Ozment, C. P. (2021). Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial. Transfusion, 61(1), 42–51. https://doi.org/10.1111/trf.16164
McMichael, Ali B. V., Kanecia O. Zimmerman, Karan R. Kumar, and Caroline P. Ozment. “Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial.Transfusion 61, no. 1 (January 2021): 42–51. https://doi.org/10.1111/trf.16164.
McMichael ABV, Zimmerman KO, Kumar KR, Ozment CP. Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial. Transfusion. 2021 Jan;61(1):42–51.
McMichael, Ali B. V., et al. “Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial.Transfusion, vol. 61, no. 1, Jan. 2021, pp. 42–51. Pubmed, doi:10.1111/trf.16164.
McMichael ABV, Zimmerman KO, Kumar KR, Ozment CP. Evaluation of effect of scheduled fresh frozen plasma on ECMO circuit life: A randomized pilot trial. Transfusion. 2021 Jan;61(1):42–51.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

January 2021

Volume

61

Issue

1

Start / End Page

42 / 51

Location

United States

Related Subject Headings

  • Thrombosis
  • Retrospective Studies
  • Plasma
  • Pilot Projects
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Hemorrhage
  • Female