How do you all keep up with ecmo baby blood product requests? We are new at this and we had a baby this weekend requiring 120cc's at a time in syringes. Presetnly our syringes expire in 4 hours so we don't make them up ahead of time.

What size syringe do you use? I know there are 60 cc syringes available. Also, I believe that for Charter Med syringes, their package insert states that a 24 hour expiration can be used for red cells in the syringe.

I worked at 2 facilities that did neonatal/infant ECMO. At both places, we provided blood in an aliquot bag rather than a syringe. We would pre-aliquot bags usually in 100 cc aliquots (depending on the size of the infant). I agree that you need to determine what the expiration of the RBCs should be; I've always used CharterMed and they specify 24 hours as long as the syringe is stored at the proper temperature.

At our facility, we split a whole unit into quad bags. We also have a cooler (rated for 12 hrs) at the pt bedside. They usually keep about 4 quads in the cooler and we keep 4 more in the blood bank ready to go. Every 12 hrs we switch out the ice, and replenish the blood as needed. We thaw the plasma/cryo and get platelets ready when requested.

At the bedside they spike the quads and pull off what they need into a syringe.

What kind of cooler is the one rated at 12 hours?

We use the igloo coolers with three bags (5 lbs each) of crushed ice. We place the blood (or plasma) between the top and middle bags. Each cooler holds up to 4 whole units of blood.