{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:17:22Z","timestamp":1783343842929,"version":"3.54.6"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Children\u2019s Miracle Network, Stead Family Children\u2019s Hospital, University of Iowa"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bleeding and clotting phenotypes are common in patients supported with Extracorporeal Membrane Oxygenation (ECMO) and are associated with increased mortality. However, tools to distinguish bleeding from clotting phenotypes remain limited. Readily available platelet indices may help characterize these phenotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied patients admitted to neonatal, pediatric, and adult intensive care units (ICUs) at two centers from 2018 to 2022, who were on ECMO and required platelet transfusions. The association between pre-transfusion platelet indices (platelet count, mean platelet volume, platelet mass index) and bleeding or clotting on subsequent day was assessed with day-level univariable and multivariable logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 268 patients receiving ECMO support (75% veno-arterial), with a median age was 51\u00a0years (IQR 18.9\u201365.6). A total of 1395 platelet transfusion events were analyzed, of which 18% were followed by bleeding and 5% by thrombosis within 24\u00a0h. After multivariable adjustment, higher pre-transfusion platelet counts independently associated with subsequent bleeding (adjusted odds ratio [aOR] 1.001,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.03) but not with subsequent thrombosis (aOR 0.99,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.18). Lower pre-transfusion mean platelet volume (MPV) were independently associated with increased bleeding risk (aOR 0.87,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.049), while MPV was not associated with thrombosis (aOR 1.03,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.47). Platelet mass index (PMI) was not independently associated with bleeding (aOR 1.00,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.80) or thrombosis (aOR 1.00,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.32). All platelet indices demonstrated poor discriminatory performance for predicting bleeding or thrombosis, with area under the curve values ranging from 0.42 to 0.55.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although platelet count and MPV were independently associated with subsequent bleeding, neither index reliably distinguished bleeding phenotypes. Improved tools are needed to predict hemostatic outcomes in patients supported with ECMO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261445354","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T15:21:30Z","timestamp":1776525690000},"page":"600-607","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between platelet indices and next-day bleeding and clotting in children and adults on extracorporeal membrane oxygenation: A retrospective study"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1375-6988","authenticated-orcid":false,"given":"Madhuradhar","family":"Chegondi","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital of Illinois"},{"name":"University of Illinois College of Medicine"},{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinth","family":"Jawahar","sequence":"additional","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-0996","authenticated-orcid":false,"given":"Aditya","family":"Badheka","sequence":"additional","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6606-1736","authenticated-orcid":false,"given":"Oliver","family":"Karam","sequence":"additional","affiliation":[{"name":"Yale Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"ECLS International Summary of statistics","year":"2024","unstructured":"ECLS International Summary of statistics. (2024, accessed 5th March 2025)."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201609-1945OC"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004417"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.673613"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002102"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2015.00116"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1708542"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/vox.70018"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591241247981"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1293518"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03584.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2860"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.04.020"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2011.05.007"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103761"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-02278-4"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.afju.2018.06.002"},{"key":"e_1_3_4_19_2","first-page":"228","article-title":"Performance of platelet mass index as a marker of severity for sepsis and septic shock in children","volume":"12","author":"Chegondi M","year":"2021","unstructured":"Chegondi M, Vijayakumar N, Billa RD, et al. Performance of platelet mass index as a marker of severity for sepsis and septic shock in children. J Pediatr Intensive Care 2021; 12: 228\u2013234. https:\/\/doi.org\/10.1055\/s-0041-1731434","journal-title":"J Pediatr Intensive Care"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04612-5"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006995"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003968"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591241301614"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2021.1961707"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.161346"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000717"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.2013.0134"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2013.130501"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-025-04811-8"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2013.843072"},{"key":"e_1_3_4_31_2","first-page":"1915","article-title":"Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus?","volume":"29","author":"Demir N","year":"2016","unstructured":"Demir N, Peker E, Ece \u0130, et al. Is platelet mass a more significant indicator than platelet count of closure of patent ductus arteriosus? 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