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Autotransfusion during extracorporeal membrane oxygenation
B Tolksdorf1, J Schmeck, A Osika
1Department of Anesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Tolksdorf-Bernd@t-online.de
The International Journal of Artificial Organs
|February 24, 2001
Summary
An autotransfusion device significantly reduced the need for allogeneic blood transfusions in patients undergoing extracorporeal membrane oxygenation (ECMO) system changes. This innovative approach safely reinfused erythrocytes, minimizing donor blood requirements.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Critical Care Medicine
Background:
- Extracorporeal membrane oxygenation (ECMO) often necessitates allogeneic blood transfusions.
- Reducing transfusion requirements is crucial for patient outcomes in ECMO therapy.
Purpose of the Study:
- To evaluate an autotransfusion device for reducing allogeneic blood transfusion needs during ECMO system changes.
- To assess the safety and compatibility of using an autotransfusion device in ECMO patients.
Main Methods:
- Studied 10 elective ECMO system changes in 7 patients.
- Compared hemoglobin levels and transfusion volumes (autologous vs. allogeneic packed red blood cells) pre- and post-device implementation.
- Monitored hemodynamic (Harrowitz index) and inflammatory markers (IL-6, IL-10, TNF-alpha, endothelin-I), and coagulation parameters.
Main Results:
- Allogeneic packed red blood cell transfusions decreased from 7 to 2 units per system change.
- No adverse effects or signs of incompatibility were observed during the 48-hour monitoring period.
- Autotransfusion effectively processed and reinfused erythrocytes from ECMO systems.
Conclusions:
- Autotransfusion devices can significantly decrease allogeneic blood transfusion requirements in ECMO patients.
- The procedure demonstrated a favorable safety profile, with no observed harmful side effects.
- This method offers a viable strategy for blood management during ECMO therapy.