Abstract：
BACKGROUND: Clinical blood resources are scarce and autologous blood transfusion for extracorporeal membrane oxygenation (ECMO) withdrawal is less studied.
OBJECTIVE: To assess the use of staged autotransfusion during ECMO decannulation.
METHODS: The study included ECMO withdrawal patients. Patients in the autologous transfusion group underwent staged transfusion during ECMO withdrawal, while those in the control group received 2.0 units of allogeneic packed red blood cells (RBCs) to increase hemoglobin (Hb). Parameters such as Hb, hematocrit (Hct), adverse events, decannulation success rate, volume of allogeneic RBC transfusions, and transfusion costs were compared.
RESULTS: A total of 82 Chinese patients were enrolled, with a mean age of 46 years, 27 were female, and the top three primary diagnoses were cardiac arrest, acute myocarditis, and severe pneumonia. There were 41 individuals in the autologous blood transfusion group and 41 in the control group. No significant differences were observed in Hb, Hct, adverse events, and the success rate for decannulation between the two groups (all P > 0.05). Compared with the control group, the volume of allogeneic RBC transfusions [0 (0∼1.50) U vs. 3.5 (1.88∼40) U, P < 0.001] and the total cost [130 (130∼390) Chinese Yuan (CNY) vs. 910 (487.50, 1040) CNY, P = 0.002] were lower in the autologous transfusion group.
CONCLUSIONS: In comparison with allogeneic RBC transfusion, staged autotransfusion during ECMO decannulation not only effectively maintained Hb levels but also reduced the requirement for allogeneic RBC transfusions. In addition, this approach decreased the associated costs and did not increase the risk of clinical adverse events.
OBJECTIVE: To assess the use of staged autotransfusion during ECMO decannulation.
METHODS: The study included ECMO withdrawal patients. Patients in the autologous transfusion group underwent staged transfusion during ECMO withdrawal, while those in the control group received 2.0 units of allogeneic packed red blood cells (RBCs) to increase hemoglobin (Hb). Parameters such as Hb, hematocrit (Hct), adverse events, decannulation success rate, volume of allogeneic RBC transfusions, and transfusion costs were compared.
RESULTS: A total of 82 Chinese patients were enrolled, with a mean age of 46 years, 27 were female, and the top three primary diagnoses were cardiac arrest, acute myocarditis, and severe pneumonia. There were 41 individuals in the autologous blood transfusion group and 41 in the control group. No significant differences were observed in Hb, Hct, adverse events, and the success rate for decannulation between the two groups (all P > 0.05). Compared with the control group, the volume of allogeneic RBC transfusions [0 (0∼1.50) U vs. 3.5 (1.88∼40) U, P < 0.001] and the total cost [130 (130∼390) Chinese Yuan (CNY) vs. 910 (487.50, 1040) CNY, P = 0.002] were lower in the autologous transfusion group.
CONCLUSIONS: In comparison with allogeneic RBC transfusion, staged autotransfusion during ECMO decannulation not only effectively maintained Hb levels but also reduced the requirement for allogeneic RBC transfusions. In addition, this approach decreased the associated costs and did not increase the risk of clinical adverse events.
摘要：
背景：临床血液资源稀缺，自体输血用于体外膜氧合（ECMO）戒断的研究较少。
目的：评估在ECMO拔管过程中分阶段自体输血的使用。
方法：本研究包括ECMO戒断患者。自体输血组患者在ECMO停药期间接受分期输血,而对照组接受2.0单位的同种异体包装红细胞（RBC）以增加血红蛋白（Hb）。Hb等参数，血细胞比容（Hct），不良事件,拔管成功率,同种异体红细胞输血量，和输血费用进行了比较。
结果：共纳入82例中国患者，平均年龄46岁,27是女性，前三名的主要诊断是心脏骤停，急性心肌炎,和严重的肺炎。自体血回输组41例,对照组41例。Hb没有观察到显著差异,HCT,不良事件,两组拔管成功率比较(均P>0.05)。与对照组相比,同种异体红细胞输血量[0(0~1.50)Uvs.3.5(1.88~40)U，P<0.001]和总成本[130(130~390)人民币(CNY)与910(487.50,1040)人民币,P=0.002]在自体输血组中较低。
结论：与同种异体红细胞输注相比，ECMO拔管过程中的分阶段自体输血不仅有效维持了Hb水平，而且减少了同种异体红细胞输血的需求。此外,这种方法降低了相关费用,并且没有增加临床不良事件的风险.
目的：评估在ECMO拔管过程中分阶段自体输血的使用。
方法：本研究包括ECMO戒断患者。自体输血组患者在ECMO停药期间接受分期输血,而对照组接受2.0单位的同种异体包装红细胞（RBC）以增加血红蛋白（Hb）。Hb等参数，血细胞比容（Hct），不良事件,拔管成功率,同种异体红细胞输血量，和输血费用进行了比较。
结果：共纳入82例中国患者，平均年龄46岁,27是女性，前三名的主要诊断是心脏骤停，急性心肌炎,和严重的肺炎。自体血回输组41例,对照组41例。Hb没有观察到显著差异,HCT,不良事件,两组拔管成功率比较(均P>0.05)。与对照组相比,同种异体红细胞输血量[0(0~1.50)Uvs.3.5(1.88~40)U，P<0.001]和总成本[130(130~390)人民币(CNY)与910(487.50,1040)人民币,P=0.002]在自体输血组中较低。
结论：与同种异体红细胞输注相比，ECMO拔管过程中的分阶段自体输血不仅有效维持了Hb水平，而且减少了同种异体红细胞输血的需求。此外,这种方法降低了相关费用,并且没有增加临床不良事件的风险.
