Evidence map›Paper›PMID 41814336›Full record

Observational studyCritical care (London, England)2026

Major haemorrhage and blood product utilisation in patients receiving VA ECMO for cardiogenic shock: a multicentre observational study (OBLEX).

Hergen Buscher, Le Thi Phuong Thao, Gennaro Martucci, Johannes Gratz, Georg Trummer, Matthieu Schmidt, Melchior Gautier, Alexis Serra, Koji Takeda, Jan-Steffen Pooth and 22 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
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

32 authors.

Hergen BuscherDepartment of Intensive Care Medicine, St. Vincent's Hospital Sydney, University of New South Wales, Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia. Hergen.buscher@svha.org.au.
Le Thi Phuong ThaoTransfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Gennaro MartucciDepartment of Anesthesia and Intensive Care, Istituto Mediterraneo Per I Trapianti E Terapie Ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy.
Johannes GratzClinical Division of General Anaesthesia and Intensive Care Medicine, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria.
Georg TrummerDepartment of Emergency Medicine, Medical Centre-University of Freiburg, Medical Faculty-University of Freiburg, Freiburg, Germany.
Matthieu SchmidtService de Médecine Intensive-Réanimation, Institut de Cardiologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.
Melchior GautierService de Médecine Intensive-Réanimation, Institut de Cardiologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.
Alexis SerraASPIRE Trials Program, Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, NY, USA.
Koji TakedaDivision of Cardiothoracic and Vascular Surgery, Columbia University College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, USA.
Jan-Steffen PoothDepartment of Emergency Medicine, Medical Centre-University of Freiburg, Medical Faculty-University of Freiburg, Freiburg, Germany.
Kevin RahnDepartment of Emergency Medicine, Medical Centre-University of Freiburg, Medical Faculty-University of Freiburg, Freiburg, Germany.
Florian GeismannDepartment of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
Matthias LubnowDepartment of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
Andrew RetterGuy's and St. Thomas' NHS Foundation Trust, London, UK.
Priya NairDepartment of Intensive Care Medicine, St. Vincent's Hospital Sydney, University of New South Wales, Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Ruan VlokRoyal North Shore Hospital, Sydney, University of NSW, St Leonards, Australia.
Maithri SiriwardenaAdult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.
James WinearlsIntensive Care, Gold Coast University Hospital, Gold Coast, University of Queensland, Brisbane, QLD, Australia.
James WalshamIntensive Care, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia.
David GattasIntensive Care Service, Royal Prince Alfred Hospital, Sydney Medical School, University of Sydney, Sydney, Australia.
Anders AnemanSouth Western Sydney Clinical School, Liverpool Hospital, South Western Sydney Local Health District, University of New South Wales, Sydney, Australia.
Bentley FulcherThe Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Sally NewmanDepartment of Intensive Care Medicine, St. Vincent's Hospital Sydney, University of New South Wales, Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Claire ReynoldsDepartment of Intensive Care Medicine, St. Vincent's Hospital Sydney, University of New South Wales, Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Anthonio ArcadipaneDepartment of Anesthesia and Intensive Care, Istituto Mediterraneo Per I Trapianti E Terapie Ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy.
Kiran ShekarAdult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.
Zoe McQuiltenTransfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Carol Hodgson *The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Vincent Pellegrino *Department of Intensive Care, The Alfred Hospital, Melbourne, VIC, Australia.
Thomas Mueller *Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
Daniel Brodie *Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
the International ECMO Network (ECMONet)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHaemorrhage and blood product usage are common in venoarterial extracorporeal membrane oxygenation (VA ECMO) and associated with increased mortality.

methodsA prospective, investigator-initiated, longitudinal observational cohort study on major haemorrhagic events in 12 ECMO centres from 3 continents for three predefined subgroups (VA ECMO initiated during cardio-pulmonary resuscitation (ECPR), after cardiothoracic surgery (CTS), for cardiogenic shock (CS)). The aim was to describe haemorrhagic complications as well as transfusion practice and anticoagulation for the whole population as well as the subgroups. In addition, independent baseline predictors for red blood cell (RBC) transfusions were evaluated.

results545 prospective patients were included between 2019 and 2022 (ECPR 149, CTS 169, CS 227). Hospital mortality was 46%. Over 2796 days 406 major haemorrhage events in 286 (52%) patients were recorded. CTS and ECPR patients had more frequent events occurring earlier in their course. 88% received RBC transfusions (1.27 (95%CI 1.22 – 1.31) units/day) with significantly more transfusions for CTS and ECPR patients. Platelet transfusion rates were highest in the CTS group (0.58 (95%CI 0.53–0.64) units/day). Haemoglobin and platelet count prior to transfusion were independent of subgroups and averaged (78 g/L (IQR 73, 84), 58 × 10^9/L (IQR 37, 85), respectively). However, platelet count prior transfusion was only marginally higher on days with major haemorrhage (74 × 10^9/L (IQR 50, 104). Systemic anticoagulation was started within the first 24 h in 83% (95% CI 80–87%) of patients, most frequently in CS patients (90%, CI 85–95%). Independent baseline predictors for RBC transfusion were ECPR (IRR 1.50, 95%CI 1.19–1.89) and prior use of antiplatelets (IRR: 1.43, 95%CI 1.13–1.80). Myocarditis and pulmonary embolism were associated with a lower rate of transfusion when compared to myocardial infarct (IRR: 0.57 (0.37–0.89), IRR: 0.67 (0.45–1.00, respectively).

conclusionHaemorrhagic complications differ in clinical subgroups and RBC transfusion exposure is by far higher than in other critically unwell populations. We identified ECPR and antiplatelet therapy as additional predictors. Transfusion practice for RBC and platelets is variable and does not always follow international guidelines.

Indexed as

Blood TransfusionExtracorporeal Membrane OxygenationHemorrhageShock, CardiogenicAgedCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective Studies

Identifiers

PMID41814336
PMCPMC13093921

What OpenQuestion holds

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LicenceCC BY-NC-ND
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.