Benefits of a lower hematocrit during extracorporeal membrane oxygenation?
OBJECTIVE
To determine the possible benefits of maintaining a lower hematocrit than that normally used (0.35 vs 0.45) in neonates treated with extracorporeal membrane oxygenation.


METHODS
Randomized cohort.


METHODS
Neonatal and pediatric intensive care units at a university hospital.


METHODS
Twenty neonates who met criteria for receiving extracorporeal membrane oxygenation from May 1988 to March 1990.


METHODS
Hematocrits were maintained at 0.35 for neonates in group 1 and 0.45 for neonates in group 2.


RESULTS
Hematocrits were measured every 4 hours. Visible clots in the major circuit components were recorded. Infants in group 1 received (mean +/- SD) 2.5 +/- 0.6 mL of packed red blood cells per hour of extracorporeal membrane oxygenation while infants in group 2 received 3.8 +/- 0.9 mL of packed red blood cells per hour of extracorporeal membrane oxygenation. In group 1, clots were noted in six of 10 oxygenators and five of 10 bladder reservoirs. In group 2, clots were found in all 10 oxygenators and bladder reservoirs.


CONCLUSIONS
Neonates' hematocrits can be maintained safely at 0.35 during extracorporeal membrane oxygenation with significantly less exposure to packed red blood cells and less clotting in the circuit.
Griffin
M P
MP
Department of Pediatrics, University of Texas Medical Branch, Galveston.
Minifee
P K
PK
Daeschner
C W
CW
Zwischenberger
J B
JB
D001777:Blood Coagulation; D016913:Blood Component Transfusion; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*