Changes in Platelet Counts in Patients Undergoing Extracorporeal Membrane Oxygenation Technique

Abstract

Platelet count disorders in patients on extracorporeal membrane oxygenation (ECMO) are intricate and involve complex mechanisms. This chapter aims to summarize knowledge on platelet count changes in the ECMO population. Thrombocytopenia occurs in about 21% during ECMO, declining over 2–3 days, persisting up to 7 days post-ECMO, with heparin-induced thrombocytopenia at 3.7%. Diagnosis relies on complete blood count with platelet count <150 G/L or rotational thromboelastometry (A5 EXTEM <35 mm and A5 FIBTEM ≥9 mm). Combination of thrombocytopenia and coagulation disorders may lead to bleeding (44.7%) or thrombosis (22.9%) in patients undergoing ECMO. Platelet testing every 6–12 hours is crucial, target in ECMO population for ≥100,000 × 10^9/L with bleeding and lower (≥50,000–100,000 × 109/L) without. Up to 50% of ECMO patients may require platelet transfusions, as per recent studies.