Table 2 Platelet course, transfusion and complications
Variable | Overall (N = 419) | Normal (> 150) (N = 20) | Mild (100–150) (N = 60) | Moderate (50–100) (N = 159) | Severe (< 50) (N = 179) | P-value | Post hoc |
|---|---|---|---|---|---|---|---|
Laboratory values | |||||||
Platelet count prior | 179 [119–253] | 324 [254–379] | 216 [155–264] | 199 [142–255] | 133 [82–197] | < 0.001 | Severe versus mild/moderate/normal*** normal versus mild/moderate** |
Difference platelet count before-after cannulation | 49 [6–102] | 66 [− 1 to 105] | 28 [0–66] | 50 [10–93] | 51 [16–112] | 0.42 | n.s |
During ECMO: minimal platelet count | 56 [37–89] | 204 [167–240] | 118 [109–128] | 68 [58–81] | 34 [23–42] | < 0.001 | Severe versus mild/moderate/normal*** normal versus mild/moderate** |
During ECMO: mean platelet count | 89 [63–129] | 228 [198–292] | 146 [1357–169] | 100 [84–116] | 61 [47–75] | < 0.001 | Severe versus mild/moderate/normal*** normal versus mild/moderate** |
Day of nadir platelet count | 4 [1–5] | 3 [2–4] | 3 [2–5] | 4 [2–5] | 4 [2–5] | 0.93 | n.s |
Platelet transfusion | |||||||
Proportion transfused | 226 (54) | 0 (0) | 8 (13) | 72 (45) | 146 (82) | < 0.001 | Severe versus mild/moderate/normal*** normal versus moderate** |
Total platelets transfused | 4 [2–7] | – | 1 [1–1.25] | 3 [1–5] | 4.50 [2–10] | < 0.001 | Severe versus mild/moderate/normal*** normal versus moderate** |
No. of days receiving platelet transfusion | 2 [1–3] | – | 1 [1–1.25] | 1 [1–2] | 2 [1–4] | < 0.001 | Severe versus mild/moderate/normal*** normal versus moderate** |
Number of platelets transfused per day on ECMO (units) | 0.63 [0.33–1.14] | – | 0.50 [0.31–0.50] | 0.41 [0.25–0.86] | 0.75 [0.44–1.31] | < 0.01 | Severe versus mild/moderate/normal*** normal versus moderate** |
Number of platelets transfused per transfusion day (units)a | |||||||
1 | 306/579 (53) | – | 8/10 (80) | 70/124 (56) | 228/445 (51) | 0.13 | n.s |
2–3 | 179/579 (31) | – | 2/10 (20) | 30/124 (24) | 147/445 (33) | 0.13 | n.s |
≥ 4 | 94/579 (16) | – | 0 (0) | 24/124 (19) | 70/445 (16) | 0.27 | n.s |
Concomitant RBC transfusion among the transfused | 221 (98) | – | 8 (100) | 69 (96) | 144 (99) | 0.38 | n.s |
Complications | |||||||
Acute kidney injury | 242 (58) | 8 (40) | 28 (47) | 89 (56) | 117 (65) | 0.02 | n.s |
Hemorrhage | 207 (49) | 1 (5) | 14 (23) | 77 (48) | 115 (64) | < 0.001 | Severe versus mild/moderate/normal*** moderate versus mild**/normal*** |
Thrombotic event | 112 (27) | 5 (25) | 9 (15) | 32 (20) | 66 (37) | 0.001 | Severe versus mild/moderate** |
Arterial thrombotic event (i.e., leg ischemia) | 63 (56) | 4 (20) | 7 (12) | 14 (9) | 38 (21) | 0.01 | Severe versus moderate** |
Venous thrombotic event (i.e., deep venous thrombosis) | 23 (21) | 2 (10) | 1 (2) | 8 (5) | 12 (7) | 0.39 | n.s |
Mechanical thrombotic event | 44 (39) | 1 (5) | 2 (3) | 15 (9) | 26 (15) | 0.07 | n.s |
28-day mortality | 187 (45) | 6 (30) | 22 (37) | 60 (38) | 99 (55) | 0.002 | Severe versus mild*/moderate** |