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Blood component use in critical care in patients with COVID-19 infection: a single-centre experience
Andrew J Doyle1, Anicee Danaee1, Charlene I Furtado1
1Department of Clinical Haematology, NHS Foundation Trust, Guy's and St Thomas, London, UK.
Insights
Critical care admissions surged during COVID-19, increasing demand for blood components. Red cell concentrates were most frequently transfused, especially in patients requiring venovenous extracorporeal membrane oxygenation (vv-ECMO).
Area of Science:
- Critical Care Medicine
- Hematology
- Infectious Diseases
Background:
- The coronavirus disease 2019 (COVID-19) pandemic led to increased critical care admissions.
- The impact of the pandemic on blood component utilization in intensive care units (ICUs) remains largely undescribed.
Purpose of the Study:
- To describe the utilization of blood components in critically ill patients during the early phase of the COVID-19 pandemic.
- To analyze blood product transfusion patterns in patients requiring venovenous extracorporeal membrane oxygenation (vv-ECMO).
Main Methods:
- A retrospective review of 265 patients admitted to a tertiary-level critical care department within the first 6 weeks of the COVID-19 outbreak.
- Analysis of blood component usage, including red cell concentrates, fresh frozen plasma, cryoprecipitate, and platelets.
Main Results:
- Fifty patients (18.9%) required blood components during their ICU stay.
- Red cell concentrates were the most commonly transfused component, with significantly higher use in patients supported by vv-ECMO (30 patients).
- Transfusion rates for fresh frozen plasma, cryoprecipitate, and platelets were low during this initial period.
Conclusions:
- Critically ill COVID-19 patients, particularly those on vv-ECMO, have a substantial demand for red cell concentrates.
- Early pandemic data indicate limited use of other blood components like plasma and platelets, potentially influenced by evolving treatment strategies.
Abstract:
There has been a significant surge in admissions to critical care during the coronavirus disease 2019 (COVID-19) pandemic. At present, the demands on blood components have not been described. We reviewed their use during the first 6 weeks of the outbreak from 3 March 2020 in a tertiary-level critical care department providing venovenous extracorporeal membrane oxygenation (vv-ECMO). A total of 265 patients were reviewed, with 235 not requiring ECMO and 30 requiring vv-ECMO. In total, 50 patients required blood components during their critical care admission. Red cell concentrates were the most frequently transfused component in COVID-19-infected patients with higher rates of use during vv-ECMO. The use of fresh frozen plasma, cryoprecipitate and platelet transfusions was low in a period prior to the use of convalescent plasma.
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