Abstract: Objective To discuss blood component usage during extracorporeal membrane oxygenation（ECMO） in neonates. Method Medical records of neonates who underwent ECMO respiratory support between January 2015 and March 2020 were retrospectively analyzed in three ECMO centers, namely Bayi hildren's Hospital,Seventh Medical Center of PLA General Hospital, Children's Hospital affiliated to Zhengzhou University, and Children's Hospital Affiliated to Chongqing University. Patients received suspended red blood cells（SRBCs）, frozen plasma, cryoprecipitate and platelet during ECMO support. This study explores the relationship between the transfusion of blood components and hospital mortality. Result A total of 41 patients were included in the study. Based on discharge outcome, they were divided into survival group （n=30）and death group（n=11）, with a hospital mortality rate of 26.8%. Overall, the daily hematocrit was maintained at （34.1±3.59）% close to the normal level. The transfusion volume of SRBCs and platelet was higher. Logistic regression analysis showed that the increased transfusion of SRBCs and platelet during neonatal ECMO was an independent risk factor for hospital mortality, and OR values were both 7.264 （95%CI 1.266~41.674）. Conclusion The usage of blood components during ECMO in death group increased significantly, of which the increased amount of SRBCs and platelet transfusion was associated with higher in-hospital mortality.

Key words: Blood transfusion, Extracorporeal membrane oxygenation, Newborn, Respiration