Abstract
76: Platelet Transfusions and Changes in Extracorporeal Life Support Oxygenator Resistance: A Retrospective Multicenter Study
ASAIO journal (1992), Vol.72(Supplement 5), pp.55-55
09/2026
DOI: 10.1097/01.mat.0001279048.57743.f1
Abstract
Background: Platelet transfusions are common during pediatric extracorporeal membrane oxygenation (ECMO), but may contribute to circuit thrombosis and impaired oxygenator function. We evaluated pre-transfusion factors associated with worsening post-transfusion oxygenator resistance.
Methods: We conducted a multicenter, retrospective study across 7 centers of children supported on ECMO who received platelet transfusions. The unit of analysis was the platelet transfusion. Oxygenator resistance was calculated as the transmembrane pressure gradient divided by ECMO blood flow. The primary outcome was worsening oxygenator resistance, defined as a post-transfusion increase at or above the 75th percentile. Generalized linear mixed models with patient-level random intercepts identified associations.
Results: Ninety patients had 606 platelet transfusions. Median age was 1 month (IQR 0,23), median weight was 3.7 kg (IQR 3.1,11.4), and 93% were supported with veno-arterial ECMO. Median oxygenator resistance change after platelet transfusion was 0.00 mmHg·min/L (IQR −1.47;2.57), though resistance increased substantially in a subset of transfusions. Higher ECMO blood flow rates (p=0.002), lower weight (p=0.044), lower pH (p=0.009), and shorter aPTT (p=0.019) were independently associated with greater odds of worsening oxygenator resistance. Pre-transfusion oxygenator resistance was significant in bivariate (p=0.003) but not multivariable analysis. As shown in Figure 1, each additional transfusion followed by worsening oxygenator resistance was associated with shorter time to circuit change (HR 1.31, p=0.020) and higher bleeding risk (HR 1.24, p=0.005) after adjustment.
Conclusions: Platelet transfusions were not associated with worsening oxygenator resistance on average, although some were followed by increased resistance, which was independently associated with circuit change and bleeding.
Details
- Title: Subtitle
- 76: Platelet Transfusions and Changes in Extracorporeal Life Support Oxygenator Resistance: A Retrospective Multicenter Study
- Creators
- Madhuradhar Chegondi - Children's Hospital of IllinoisAravinth Jawahar - University of IowaMathew P. Malone - Arkansas Children's HospitalPaul Martinez - Miami Children's HospitalSonia Labarinas - The University of Texas Health Science Center at HoustonErik C Madsen - Cardinal Glennon Children’s Medical CenterSantosh Kaipa - Children's Nebraska, University of Nebraska, Omaha, USAAditya Badheka - University of IowaLaura Ellwin Fix - University of RichmondOliver Karam - Yale University
- Resource Type
- Abstract
- Publication Details
- ASAIO journal (1992), Vol.72(Supplement 5), pp.55-55
- DOI
- 10.1097/01.mat.0001279048.57743.f1
- ISSN
- 1058-2916
- eISSN
- 1538-943X
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 09/2026
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9985238182402771
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