25 February 2022

High levels of red blood cell transfusions can be dangerous for babies receiving extracorporeal membrane oxygenation (ECMO), a conference has heard.

ECMO is used in infants with respiratory failure to provide enough oxygen while the lungs and heart can rest or heal. Now US researchers have found that when giving newborns on ECMO red blood cell transfusions, a high volume can be dangerous.

Drs Brian Stansfield and Jessica Gancar from the Medical College of Georgia and Children’s Hospital of Georgia, USA, analysed information on 248 newborns treated from 2002 to 2019, of whom 93% survived. Details of their blood product transfusions, including red blood cells as well as plasma and platelets, were analysed alongside rates of mortality and complications.

They showed that the higher volume of these oxygen-carrying blood cells the babies received, the higher their mortality rate.

“We identified a clear linear relationship between mortality and red blood cell transfusion volume”, Dr Gancar says. “Specifically, for every transfusion of red cells while on ECMO, a baby’s chances of survival decreased by 14%.”  

Dr Stansfield said: "You have to have sufficient blood volume to make the whole system work. Our transfusion practice is when the haematocrit hits 35% we will transfuse.

“Most ECMO centres still have a threshold of 40%, which means they are transfusing more. Others transfuse at 30%. So, in our program we also have to ask the question if we are accepting some unnecessary risks. Could we get by with less?"

Dr Gancar presented the findings at the Southern Society for Pediatric Research meeting held from 13th to 15th February in New Orleans and online.

She added: “We think this supports the overall trend of being more restrictive in transfusion practices and being even more mindful about when you give transfusions and when you don’t while a child is on ECMO.”

Source: Medical College of Georgia

Link: https://jagwire.augusta.edu/red-blood-cell-transfusions-can-increase-mortality-rates-of-newborns-on-ecmo-study-finds/

Disclaimer: The news stories shared on this site are used as a way to inform our members and followers of updates and relevant information happening in Haematology. The BSH does not endorse the content of news items from external sources, and is not in a position to verify the findings, accuracy or the source of any studies mentioned. Any medical or drugs information is provided as an information resource only, and is not to be relied on for any diagnostic or treatment purposes.

News service provided by Englemed News.