Blood use during extracorporeal membrane oxygenation

An analysis of the transfusion records of 91 neonatal patients subjected to extracorporeal membrane oxygenation (ECMO) is reported. Mean daily blood usage was 250 mL of red cells (RBCs), 80 mL of fresh-frozen plasma, and 2 units of platelets. Average time on ECMO was 4.6 days. Group O or ABO type-specific RBCs and group AB or ABO type-specific plasma products and platelets were transfused. RBCs were not washed, and neither RBCs nor other components were tested for anticytomegalovirus (CMV) or irradiated. No cases of posttransfusion CMV infection or graft-versus-host disease were observed. Hemolysis in eight patients was traced to occlusions in the ECMO circuit. All but three patients survived ECMO. Contrary to a previous report, an active ECMO program for neonatal patients imposes a minimal burden on the hospital transfusion service.