Patient‐tailored platelet transfusion practices for children supported by extracorporeal membrane oxygenation

Background and Objectives Extracorporeal membrane oxygenation (ECMO) serves as cardiopulmonary therapy in critically ill patients with respiratory/heart failure and often necessitates multiple blood product transfusions. The administration of platelet transfusions during ECMO is triggered by the presence or risk of significant bleeding. Most paediatric ECMO programmes follow guidelines that recommend a platelet transfusion threshold of 80–100 × 109/L. To reduce exposure to platelets, we developed a practice to dynamically lower the threshold to ~20 × 109/L. We describe our experience with patient‐tailored platelet thresholds and related bleeding outcomes. Materials and Methods We retrospectively evaluated our platelet transfusion policy, bleeding complications and patient outcome in 229 ECMO‐supported paediatric patients in our unit. Results We found that more than 97.4% of patients had a platelet count