Impact of cannula design on packed red blood cell transfusions: technical advancement to improve outcomes in extracorporeal membrane oxygenation

Gennaro Martucci*, Giovanna Pauarello, Giovanna Occhipinti, Giuseppe Raffa, Fabio Tuzzolino, Guido Capitanio, Tiziana Carollo, Giovanni Lino, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Roberto Lorusso, Antonio Arcadipane

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Technological improvement has contributed to making veno-venous extracorporeal membrane oxygenation (VV-ECMO) safer and easier, spreading its use in acute respiratory failure (ARF).

Methods: This is a retrospective observational study carried out in the ECMO center at IRCCS-ISMETT, a medical center focused on end-stage organ failure treatment in Italy. We investigated the effect of different cannula designs on the amount of blood product transfused. Eighty-nine consecutive patients affected with ARF on VV-ECMO from 2008 to 2016 were compared according to type of cannulation: older percutaneous cannula (Standard group, 52 patients) and HLS(C) BIOLINE-coated, but with shorter drainage cannula (BIOLINE group, 37 patients).

Results: The two study groups were comparable in terms of baseline characteristics [age, body mass index (BMI), Simplified Acute Physiology Score (SAPS-II), Sequential Organ Failure Assessment (SOFA), Predicting Death For Severe ARDS on VV-ECMO (PRESERVE) score] and ECMO management [median hematocrit (Htc), platelet nadir, antithrombin III (AT III), heparin, activated partial thromboplastin time (APTT)]. In the BIOLINE group, a lower amount of packed red blood cells (pRBC) was transfused considering both total number [4 units, interquartile range (IQR) 1-9 vs. 12 units, IQR 5.5-21; P

Conclusions: More biocompatible and shorter drainage cannula may represent one of the contributing factors to a reduction in transfusions and costs of VV-ECMO in the current ongoing technological improvement in ECMO.

Original languageEnglish
Pages (from-to)5813-5821
Number of pages9
JournalJournal of Thoracic Disease
Volume10
Issue number10
DOIs
Publication statusPublished - Oct 2018

Keywords

  • intensive care unit (ICU) costs
  • large bore cannula
  • acute respiratory distress syndrome (ARDS)
  • transfusion
  • packed red blood cells (pRBC)
  • CARDIOPULMONARY BYPASS CIRCUITS
  • ACUTE RESPIRATORY-FAILURE
  • LIFE-SUPPORT
  • VENOVENOUS ECMO
  • EXPERIENCE
  • ADULTS
  • MODEL
  • ARDS
  • CARE
  • MANAGEMENT

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