(175) Impact of a Tranexamic Acid Infusion in Bleeding Extracorporeal Membrane Oxygenation Patients

Introduction: This study was conducted to assess whether use of a tranexamic acid (TXA) continuous infusion reduced transfusion requirements without increasing thrombotic events in patients requiring extracorporeal membrane oxygenation (ECMO) support.

Methods: This was a single-center retrospective analysis of patients who met International Society on Thrombosis and Haemostasis criteria for major bleeding and received at least 2,000 mg of a 6.5 mg/kg/hr TXA infusion. The primary outcome was the average volume (mL/hr) of blood products transfused during ECMO, compared with and without concomitant TXA administration. Secondary outcomes included blood factor product and additional hemostatic medication administration, thrombotic complications, chest tube output, rates of surgical re-exploration, hospital and intensive care unit length of stay, and mortality.

Results: Data from 35 patients were analyzed. Patients received more blood products per hour during the TXA infusion than without (60.9 [23.1-197.3] vs 1.1 [0.3-2.7]).

Conclusions: Initiation of a TXA infusion in bleeding ECMO patients did not significantly reduce transfusion requirements, but also did not increase the risk of a thromboembolic event. Further prospective evaluation with a comparator group is needed to confirm these results.