{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:02:04Z","timestamp":1791903724414,"version":"4.3.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"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":[[2026,5]]},"abstract":"\n Objectives<\/jats:title>\n The platelet trigger at which to transfuse platelets to prevent bleeding complications in patients supported with extracorporeal membrane oxygenation (ECMO) is unclear. We aimed to elucidate the association between platelet count and bleeding sequelae in this patient population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a single-center retrospective study of all adult patients who received ECMO support from 2017 to 2022. Patients were stratified into two groups: \u201cnon-thrombocytopenic\u201d (>30 \u00d7 10\n 3<\/jats:sup>\n cells \/\u03bcL) versus \u201cthrombocytopenic\u201d (\u226430 \u00d7 10\n 3<\/jats:sup>\n cells \/\u03bcL). Multivariable logistic regression was used to determine the association between thrombocytopenia and bleeding complications; covariates were selected a priori. A post-hoc analysis investigating platelet transfusion status and nadir platelet count as an ordinal variable was also performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 291 VV- and VA-ECMO patients, 69 (24%) were categorized as \u201cthrombocytopenic\u201d and 144 (50%) experienced at least one major bleeding event. Compared to \u201cnon-thrombocytopenic\u201d patients, \u201cthrombocytopenic\u201d patients were more likely to be male (\n p<\/jats:italic>\n = 0.049), to require veno-arterial central canulation (\n p<\/jats:italic>\n < 0.001), and to have been on dialysis (\n p<\/jats:italic>\n < 0.001). Confounded by a 72% prophylactic transfusion rate, \u201cThrombocytopenia\u201d was not associated with an increased risk of major bleeding (aOR: 0.59 [95% CI: 0.31\u20131.10]). However, in patients with a nadir platelet count between 31 and 50 \u00d7 10\n 3<\/jats:sup>\n cells\/\u03bcL, the 63% with a prophylactic platelet transfusion had a significant reduction in major bleeding complications (\n p<\/jats:italic>\n = 0.003).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our findings suggest that a platelet transfusion trigger of \u226450 \u00d7 10\n 3<\/jats:sup>\n cells\/\u03bcL is of benefit for prophylaxis against bleeding during ECMO support.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/02676591251364481","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T21:38:06Z","timestamp":1753911486000},"page":"392-400","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Re-evaluating the association between thrombocytopenia and bleeding in extracorporeal membrane oxygenation (ECMO)"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8049-7624","authenticated-orcid":false,"given":"Albert","family":"Leng","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Rando","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-2246","authenticated-orcid":false,"given":"Manuj","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armaan","family":"Akbar","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Shou","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Kalra","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medicine"},{"name":"Department of Surgery, Thomas Jefferson University, Sidney Kimmel Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn J. R.","family":"Whitman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"On behalf of HERALD Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.07.046"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001230"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31816f7cf7"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc12681"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)01792-1"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.02.012"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-016-0196-7"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.02.008"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0475-6"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06593-x"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2014.12.001"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06031-4"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2018.00157"},{"key":"e_1_3_7_16_2","volume-title":"Dual antiplatelet therapy following percutaneous coronary intervention: clinical and economic impact of standard versus extended duration. Canadian agency for drugs and technologies in health","author":"Wells GA","year":"2019","unstructured":"Wells GA, Elliott J, Kelly S, et al. Dual antiplatelet therapy following percutaneous coronary intervention: clinical and economic impact of standard versus extended duration. Canadian agency for drugs and technologies in health. 2019. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542937\/ Accessed 28 May 2023."},{"issue":"9","key":"e_1_3_7_17_2","first-page":"1550","article-title":"Transfusion thresholds for adult respiratory extracorporeal life support: an expert consensus document","volume":"36","author":"Singh G","year":"2020","unstructured":"Singh G, Nahirniak S, Arora R, et al. Transfusion thresholds for adult respiratory extracorporeal life support: an expert consensus document. Can J Cardiol 2020; 36(9): 1550\u20131553.","journal-title":"Can J Cardiol"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04612-5"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001643"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-41773-3"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/026765919400900404"},{"key":"e_1_3_7_22_2","volume-title":"Presented as poster at AATS annual meeting","author":"Leng A","year":"2023","unstructured":"Leng A, Pan A, Rando R, et al. Re-Evaluating the association between thrombocytopenia and bleeding in extracorporeal membrane oxygenation (ECMO). Presented as poster at AATS annual meeting, 2023."}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251364481","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591251364481","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251364481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:23:30Z","timestamp":1778127810000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591251364481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/02676591251364481"],"URL":"https:\/\/doi.org\/10.1177\/02676591251364481","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]}}}