Implementation of a Standardized Transfusion Protocol for Cardiac Patients Treated With Venoarterial ECMO Is Associated With Decreased Blood Component Utilization and May Improve Clinical Outcome

ncbi.nlm.nih.gov September 13, 2019

The data indicate that implementation of a standardized transfusion protocol, using more restrictive transfusion indications in cardiac ECMO patients, was associated with reduced blood product utilization, decreased complications, and improved survival.

This multi-departmental approach facilitates better communication and adherence to consensus clinical decision making between ICU, surgery, and transfusion service and optimizes care of complicated and acutely ill patients.

Comorbidities were similar between the 2 eras, as well as the pre-ECMO ejection fraction (P = .568) and duration on ECMO (P = .278). Transfusion utilization data revealed statistically significant decreases in almost all blood components and a savings in blood component acquisition costs of 51%.

Data were retrospectively reviewed for the first 30 consecutive cardiac ECMO patients prior and post implementation of the ECMO transfusion protocol. Diagnoses, laboratory results, blood component utilization, and outcomes were collected and analyzed.