Evidence map›Paper›PMID 31837026›Full record

ArticleTransfusion2020

Blood product transfusion and mortality in neonatal extracorporeal membrane oxygenation.

Sarah D Keene, Ravi Mangal Patel, Brian K Stansfield, Joel Davis, Cassandra D Josephson, Anne M Winkler

Abstract read
In one paragraph

Article in Transfusion, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024
    Pooled it
  3. Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024
    Pooled it
  4. Prophylactic Transfusion Strategies in Children Supported by Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024
    Pooled it
  5. Pooled it
  6. Article
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  8. Variation in Neonatal Transfusion Practice.The Journal of pediatrics · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sarah D KeeneChildren's Healthcare of Atlanta, Atlanta, Georgia.ORCID 0000-0003-2831-8662
Ravi Mangal PatelChildren's Healthcare of Atlanta, Atlanta, Georgia.ORCID 0000-0002-7444-5550
Brian K StansfieldMedical College of Georgia, Augusta University, Augusta, Georgia.ORCID 0000-0002-1105-8895
Joel DavisChildren's Healthcare of Atlanta, Atlanta, Georgia.
Cassandra D JosephsonChildren's Healthcare of Atlanta, Atlanta, Georgia.
Anne M WinklerEmory University School of Medicine, Atlanta, Georgia.

Funding

Serious Hazards of Transfusion & Cellular Therapies: Mechanisms and InterventionP01HL086773 · NHLBI · EMORY UNIVERSITY · PI ROBACK, JOHN D · 2008 to 2019
$17.9M
Inflammation and retinopathy of prematurityR01EY029318 · NEI · AUGUSTA UNIVERSITY · PI STANSFIELD, BRIAN KEVIN · 2019 to 2023
$2.2M
Red Cell Transfusion, Severe Anemia and Necrotizing EnterocolitisK23HL128942 · NHLBI · EMORY UNIVERSITY · PI PATEL, RAVI MANGAL · 2016 to 2019
$665k
NEI NIH HHS R01 EY029318NHLBI NIH HHS K23 HL128942NHLBI NIH HHS P01 HL086773
6 · The paper itself

Abstract

backgroundNeonates receiving extracorporeal membrane oxygenation (ECMO) support are transfused large volumes of red blood cells (RBCs) and platelets (PLTs). Transfusions are often administered in response to specific, but largely unstudied thresholds. The aim of this study is to examine the relationship between RBC and PLT transfusion rates and mortality in neonates receiving ECMO support. STUDY DESIGN AND

methodsWe retrospectively examined outcomes of neonates receiving ECMO support in the neonatal intensive care unit (NICU) for respiratory failure between 2010 and 2016 at a single quaternary-referral NICU. We examined the association between RBC and PLT transfusion rate (mL per kg per day) and in-hospital mortality, adjusting for confounding by using a validated composite baseline risk score (Neo-RESCUERS).

resultsAmong the 110 neonates receiving ECMO support, in-hospital mortality was 28%. The median RBC transfusion rate (mL/kg/d) after cannulation was greater among non-survivors, compared to survivors: 12.4 (IQR 9.3-16.2) versus 7.3 (IQR 5.1-10.3), p < 0.001. Similarly, PLT transfusion rate was greater among non-survivors: 22.9 (9.3-16.2) versus 12.1 (8.4-20.1), p = 0.02. After adjusting for baseline mortality risk, both RBC transfusion (adjusted relative risk per 5 mL/kg/d increase: 1.33; 95% CI 1.05-1.69, p = 0.02) and PLT transfusion (adjusted relative risk per 5 mL/kg/d increase: 1.12; 95% CI 1.02-1.23, p = 0.02) were both associated with in-hospital mortality.

conclusionsRBC and PLT transfusion rates are associated with in-hospital mortality among neonates receiving ECMO. These data provide a basis for future studies evaluating more restrictive transfusion practices for neonates receiving ECMO support.

Indexed as

Blood TransfusionErythrocyte TransfusionExtracorporeal Membrane OxygenationHospital MortalityHumansInfant, NewbornIntensive Care UnitsPlatelet TransfusionRetrospective Studies

Identifiers

PMID31837026
PMCPMC7433883

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.