{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:18:25Z","timestamp":1791346705713,"version":"4.3.1"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      As international guidelines suggest keeping the platelet count between 50 and 100 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L in children on extracorporeal membrane oxygenation (ECMO), platelet transfusions are administered to two-thirds of ECMO days, and up to 70% of these patients still bleed. We aim to describe outcomes in critically ill children who develop severe thrombocytopenia on ECMO.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Single-center retrospective study, enrolling critically ill children on ECMO admitted at Children\u2019s Memorial Hermann, TX, between 1\/2018 and 12\/2022, with at least one platelet count below 50 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L (severe thrombocytopenia). Platelet counts were measured four times a day. We report platelet transfusion, bleeding, hemolysis, and clotting events within 6\u00a0h after transfusion, as well as ECMO duration and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 54 patients representing 337 ECMO days and 1190 platelet counts. Median weight was 3.7\u00a0kg and 54% were male. Severe thrombocytopenia was observed in 56% of platelet counts. Severe thrombocytopenia was not associated with bleeding in the subsequent 6\u00a0h (18% vs 20%,\n                      <jats:italic>p<\/jats:italic>\n                      = .95), but was associated with more frequent platelet transfusions (18% vs 11%,\n                      <jats:italic>p<\/jats:italic>\n                      = .001). There was no correlation between time spent with severe thrombocytopenia and the duration of ECMO (R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.03). While the time spent with severe thrombocytopenia was not associated with on-ECMO mortality rate (\n                      <jats:italic>p<\/jats:italic>\n                      = .36), there was an association with in-hospital mortality rate (\n                      <jats:italic>p<\/jats:italic>\n                      = .003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate a restrictive platelet transfusion strategy is not associated with higher proportions of subsequent bleeding, duration of ECMO, or on-ECMO mortality rate. Multicenter studies are needed to evaluate further the appropriateness of this strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591241247981","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T16:08:51Z","timestamp":1713283731000},"page":"590-598","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7234-705X","authenticated-orcid":false,"given":"Sonia","family":"Labarinas","sequence":"first","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpana","family":"Norbisrath","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Johnson","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Meliones","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Greenleaf","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Salazar","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Institute, Pediatric Cardiac Critical Care, Advanced Cardiopulmonary Therapies and Transplantation, University of Texas- Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Karam","sequence":"additional","affiliation":[{"name":"Pediatric Critical Care, Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"ELSO. ECLS International summary of statistics https:\/\/www.elso.org\/registry\/internationalsummaryandreports\/internationalsummary.aspx (2023 accessed 12\/03\/2023)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201609-1945OC"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001652"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004417"},{"key":"e_1_3_3_6_2","unstructured":"Karam O Birch R Glynn S et al. Pre-transfusion platelet counts in critically ill children with extracorporeal membrane oxygenation. In: Pediatric Academic Societies Meeting. Washington DC USA. April 27- May 1 2023 paper no. 732.401. Washington: PAS."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16869"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002160"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.826477"},{"key":"e_1_3_3_10_2","volume-title":"ELSO anticoagulation guideline","author":"ELSO","year":"2014","unstructured":"ELSO. ELSO anticoagulation guideline, https:\/\/www.elso.org\/Portals\/0\/Files\/elsoanticoagulationguideline8-2014-table-contents.pdf (2014, accessed 12\/03\/2023)."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003968"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1708542"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.771563"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.09.100"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202110-2359OC"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000616"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241247981","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591241247981","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241247981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:34:35Z","timestamp":1777656875000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591241247981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/02676591241247981"],"URL":"https:\/\/doi.org\/10.1177\/02676591241247981","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}