Factors associated with hemolysis during extracorporeal membrane oxygenation (ECMO)—Comparison of VA- versus VV ECMO

Autor: Matthias Lubnow, Dirk Lunz, Florian Zeman, Karla Lehle, Maik Foltan, Thomas Mueller, Alois Philipp, Hannah Appelt
Rok vydání: 2020
Předmět:
Male
Blood transfusion
Physiology
medicine.medical_treatment
Cardiovascular Medicine
030204 cardiovascular system & hematology
Biochemistry
Vascular Medicine
0302 clinical medicine
Risk Factors
Animal Cells
Interquartile range
Blood Flow
Immune Physiology
Medicine and Health Sciences
Innate Immune System
Multidisciplinary
Hematology
Middle Aged
Thrombosis
Clinical Laboratory Sciences
Hemolysis
Body Fluids
Cardiac surgery
Blood
surgical procedures
operative
Cardiovascular Diseases
Anesthesia
Medicine
Cytokines
Female
Anatomy
Cellular Types
Research Article
Adult
Platelets
medicine.medical_specialty
Science
Immunology
Blood Plasma
Catheterization
03 medical and health sciences
Extracorporeal Membrane Oxygenation
Diagnostic Medicine
Extracorporeal membrane oxygenation
medicine
Humans
Blood Transfusion
Hemoglobin
Blood Coagulation
Survival rate
Aged
Retrospective Studies
Blood Cells
Coagulation Disorders
Transfusion Medicine
business.industry
Biology and Life Sciences
Proteins
030208 emergency & critical care medicine
Cell Biology
Molecular Development
medicine.disease
Immune System
business
Complication
Developmental Biology
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 1, p e0227793 (2020)
ISSN: 1932-6203
Popis: Venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO) are effective support modalities to treat critically ill patients. ECMO-associated hemolysis remains a serious complication. The aim was to disclose similarities and differences in VA- and VV ECMO-associated hemolysis. This is a retrospective single-center analysis (January 2012 to September 2018) including 1,063 adult consecutive patients (VA, n = 606; VV, n = 457). Severe hemolysis (free plasma hemoglobin, fHb > 500 mg/l) during therapy occurred in 4% (VA) and 2% (VV) (p≤0.001). VV ECMO showed significantly more hemolysis by pump head thrombosis (PHT) compared to VA ECMO (9% vs. 2%; p≤0.001). Pretreatments (ECPR, cardiac surgery) of patients who required VA ECMO caused high fHb pre levels which aggravates the proof of ECMO-induced hemolysis (median (interquartile range), VA: fHb pre: 225.0 (89.3-458.0); VV: fHb pre: 72.0 (42.0-138.0); p≤0.001). The survival rate to discharge from hospital differed depending on ECMO type (40% (VA) vs. 63% (VV); p≤0.001). Hemolysis was dominant in VA ECMO patients, mainly caused by different indications and not by the ECMO support itself. PHT was the most severe form of ECMO-induced hemolysis that occurs in both therapies with low frequency, but more commonly in VV ECMO due to prolonged support time.
Databáze: OpenAIRE
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