ABSTRACT
【Objective】 To analyze the blood transfusion strategies in extracorporeal membrane oxygenation (ECMO) recievers in our hospital, so as to explore the clinical application and efficacy of blood transfusion in patients on ECMO. 【Methods】 Data from patients on ECMO treatment in our hospital from October 2017 to October 2021 was collected. The blood transfusion data and coagulation monitoring indexes during different ECMO modes were analyzed, and the efficacy of blood transfusion was evaluated. 【Results】 No difference in the number of blood transfusions was noticed by ECMO treatment modes.The transfusion units of red blood cells, plasma and platelets in VA mode were (28.35±14.60) U, (7 367.78±5 194.33) mL and (7.04±5.10) therapeutic volumes, which were higher than those in VV mode, i. e. (18.67±21.50) U, (4 836.67±6 640.50) mL and (3.60±7.47) therapeutic dose, respectively.In VA-ECMO mode, the Hb level and platelet count before ECMO treatment were (126.44±23.9) g/L and (223.84±67.62) × 109/L, which were significantly higher than those after treatment (91.02±21.48) g/L and (172.86±127.73)×109/L.In VV-ECMO mode, the APTT before ECMO treatment was (35.28±8.73) s, which was shorter than that after treatment (41.96±13.69) s. The levels of fibrinogen, Hb and platelet count were (3.80±1.85) g/L, (123.81±33.77) g/L and (175.72±98.91)×109/L, which were significantly higher than the levels after treatment (2.78±1.08) g/L, (92.31±17.38) g/L and (125.31±98.14)×109/L, respectively. 【Conclusion】 There are differences in the amount of blood transfusion among different modes of ECMO treatment. As blood transfusion is a necessary support to ensure ECMO treatment, the monitoring of coagulation index is conducive to reduce blood transfusion, improve the efficiency of blood transfusion and benefit to patient safety.
ABSTRACT
Massive blood loss and blood transfusion constantly occur in liver transplantation. Over the past two decades, the amount of blood transfusion during the perioperative period has been decreased dramatically along with the continual maturity of liver transplantation techniques. The goal of liver transplantation without blood transfusion has been achieved. Since bleeding and blood transfusion are correlated with poor prognosis after liver transplantation, reducing bleeding and unnecessary blood transfusion has become the key objective during perioperative period of liver transplantation. In this article, adverse effects of allogeneic blood transfusion during perioperative period of liver transplantation, coagulation function monitoring of patients with end-stage liver disease, blood transfusion management of liver transplant recipients and the strategies of reducing perioperative blood transfusion in liver transplantation were summarized, aiming to provide reference for reducing the requirement of blood transfusion during perioperative period of liver transplantation.