Transfusion in Neonatal Extracorporeal Membrane Oxygenation: A Best Practice Review

Goeto Dantes; Sarah Keene

doi:10.1016/j.clp.2023.07.003

Transfusion in Neonatal Extracorporeal Membrane Oxygenation: A Best Practice Review

Clin Perinatol. 2023 Dec;50(4):839-852. doi: 10.1016/j.clp.2023.07.003. Epub 2023 Aug 17.

Authors

Goeto Dantes¹, Sarah Keene²

Affiliations

¹ Department of Surgery, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA; Emory University School of Medicine, Emory University, Atlanta, GA, USA. Electronic address: gdantes@emory.edu.
² Emory University School of Medicine, Emory University, Atlanta, GA, USA; Department of Neonatology, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA; Emory + Children's Pediatric Institute, Atlanta, GA, USA.

PMID: 37866851
DOI: 10.1016/j.clp.2023.07.003

Abstract

Extracorporeal Membrane Oxygenation (ECMO) is an important tool for managing critically ill neonates. Bleeding and thrombotic complications are common and significant. An understanding of ECMO physiology, its interactions with the unique neonatal hemostatic pathways, and appreciation for the distinctive risks and benefits of neonatal transfusion as it applies to ECMO are required. Currently, there is variability regarding transfusion practices, related to changing norms and a lack of high-quality literature and trials. This review provides an analysis of the neonatal ECMO transfusion literature and summarizes available best practice guidelines.

Keywords: Blood; Coagulopathy; ECMO; Neonatal; Platelets; Thresholds; Transfusions.

Publication types

Review

MeSH terms

Blood Transfusion
Extracorporeal Membrane Oxygenation*
Hemorrhage / therapy
Humans
Infant, Newborn
Thrombosis* / therapy