Evidence map›Paper›PMID 32304461›Full record

Observational studyAnesthesia and analgesia2020

Blood Utilization and Clinical Outcomes in Extracorporeal Membrane Oxygenation Patients.

Caroline X Qin, Lekha V Yesantharao, Kevin R Merkel, Dheeraj K Goswami, Alejandro V Garcia, Glenn J R Whitman, Steven M Frank, Melania M Bembea

Open access · greenAbstract readComparative StudyObservational Study
In one paragraph

Observational study in Anesthesia and analgesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 20% of its field
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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. 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
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Caroline X QinFrom the Departments of Anesthesiology/Critical Care Medicine.
Lekha V YesantharaoFrom the Departments of Anesthesiology/Critical Care Medicine.
Kevin R MerkelFrom the Departments of Anesthesiology/Critical Care Medicine.
Dheeraj K GoswamiFrom the Departments of Anesthesiology/Critical Care Medicine.
Alejandro V GarciaSurgery (Pediatric).
Glenn J R WhitmanSurgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
Steven M FrankFrom the Departments of Anesthesiology/Critical Care Medicine.
Melania M BembeaFrom the Departments of Anesthesiology/Critical Care Medicine.
Johns Hopkins University · US

Funding

Sleep and Circadian Dysfunction, Brain and Neurobehavioral Development in AutismP50HD103538 · NICHD · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI S. Ali Fatemi, Bradley L Schlaggar · 2020 to 2026
$9.9M
Biomarkers of Brain Injury in Critically-Ill Children on Extracorporeal Membrane Oxygenation (ECMO)R01NS106292 · NINDS · JOHNS HOPKINS UNIVERSITY · PI BEMBEA, MELANIA MARIA · 2019 to 2023
$3.1M
Leveraging biomarkers of traumatic brain injury in adults to assess pediatric neurocritical illnessR21HD096389 · NICHD · JOHNS HOPKINS UNIVERSITY · PI BEMBEA, MELANIA MARIA · 2018 to 2019
$421k
NICHD NIH HHS P50 HD103538NICHD NIH HHS R21 HD096389NINDS NIH HHS R01 NS106292
6 · The paper itself

Abstract

backgroundPatients requiring extracorporeal membrane oxygenation (ECMO) support are critically ill and have substantial transfusion requirements, which convey both risks and benefits. A retrospective analysis was conducted to assess the association between blood component administration and adverse outcomes in adult, pediatric, and neonatal ECMO patients.

methodsWe evaluated 217 ECMO patients at a single center hospitalized between January 2009 and June 2016. Three cohorts (88 adult, 57 pediatric, and 72 neonatal patients) were included for assessment of patient characteristics, blood utilization, and clinical outcomes. Univariable and multivariable analyses were used to assess the association between transfusions and clinical outcomes (primary outcome: mortality and secondary outcomes: morbid events). The analysis included the main exposure of interest (total number of blood component units transfused) and potential confounding variables (age group cohort, case mix index, sex, ECMO mode and duration, and primary ECMO indication).

resultsAfter adjustment for confounders, with each additional blood component unit transfused, there was an estimated increase in odds for mortality by 1% (odds ratio [OR] = 1.01; 95% confidence interval [CI], 1.00-1.02; P = .013) and an increase in odds for thrombotic events by 1% (OR = 1.01; 95% CI, 1.00-1.02; P = .007). Mortality was higher in the adult (57 of 88; 64.8%) and pediatric (37 of 57; 64.9%) than in the neonatal cohort (19 of 72; 26.4%) (P < .0001). Median total blood components transfused per day followed a similar pattern for the adult (2.3 units; interquartile range [IQR] = 0.8-7.0), pediatric (2.9 units; IQR = 1.1-10), and neonatal (1.0 units; IQR = 0.7-1.6) cohorts (P < .0001). Over the entire hospitalization, the total median blood components transfused was highest in the neonatal (41 units; IQR = 24-94) and pediatric (41 units; IQR = 17-113) compared to the adult (30 units; IQR = 9-58) cohort (P = .007). There was no significant interaction between total units transfused over the hospital stay and age cohort for mortality (P = .35).

conclusionsGiven the association between transfusion and adverse outcomes, effective blood management strategies may be beneficial in ECMO patients.

Indexed as

Blood TransfusionExtracorporeal Membrane OxygenationAdolescentAdultAge FactorsBaltimoreChildChild, PreschoolCritical IllnessDatabases, FactualFemaleHumansInfantInfant, NewbornMaleMiddle Aged

Identifiers

PMID32304461
PMCPMC7853404
OpenAlexW3016827625

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.