Severe Thrombocytopenia in Adults with Severe Acute Respiratory Distress Syndrome: Impact of Extracorporeal Membrane Oxygenation Use. Issue 6 (November 2016)

• Record Type: Journal Article
• Authors: Dzierba, Amy L.; Roberts, Russel; Muir, Justin; Alhammad, Abdullah; Schumaker, Greg; Clark, Jacqueline; Ruthazer, Robin; Devlin, John W.
• Is Part Of: ASAIO journal. Volume 62:Issue 6(2016)
• Publication Date: 2016-11
• Subjects: platelet -- acute respiratory distress syndrome -- extracorporeal membrane oxygenation -- intensive care unit; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000000415
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Extracorporeal membrane oxygenation (ECMO) use is perceived to cause thrombocytopenia (T), but the role of non-ECMO factors in the development of T remains unclear. We sought to evaluate the incidence and factors associated with severe T (platelet count ⩽ 50, 000/μl) in adults with severe acute respiratory distress syndrome (ARDS) managed with or without ECMO. The ECMO (n = 32) versus the non-ECMO (n = 53) groups had a similar baseline platelet count (214, 000 vs. 179, 000/μl), Acute Physiology and Chronic Health Evaluation (APACHE) II score ( p = 0.13), unfractionated heparin (UFH) exposure ( p = 0.62), and severe T incidence (25 vs . 19%, p = 0.5). Although the APACHE II score ( p = 0.01), presence of liver failure ( p = 0.08), and platelet transfusion ( p = 0.0009) were different between the severe T (18/85 [21%]) and non-severe T groups (67/85 [79%]), the incidence of septic shock ( p = 0.64), heparin infusion use ( p = 0.41), exposure to non-heparin T-causing medications ( p = 0.77) and ECMO use ( p = 0.5) were not. An adjusted multivariate linear regression model revealed that only the APACHE II score was independently associated with the development of severe T ( p = 0.01) but use of ECMO was not ( p = 0.32) ECMO use may not affect the incidence of severe T among adults with severe ARDS. Larger studies that are prospective in nature are required to confirm this finding. Abstract : Supplemental Digital Content is available in the text.