Automated and cost-efficient early detection of hemolysis in patients with extracorporeal life support: Use of the hemolysis-index of routine clinical chemistry platforms
| Autor: | Madeleen Bosma, Sander Rigter, Chris M. Hackeng, Frans Waanders, Douwe Van Loon, H.P. Van Schaik, Erik Scholten |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male endocrine system Cost-Benefit Analysis Early detection Critical Care and Intensive Care Medicine Hemolysis Extracorporeal 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Humans Medicine In patient Aged Retrospective Studies business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Early Diagnosis 030228 respiratory system Chemistry Clinical Anesthesia Life support Free hemoglobin Female Hemolysis index business Blood drawing |
| Zdroj: | Journal of Critical Care. 51:29-33 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2019.01.028 |
| Popis: | Purpose Patients with extracorporeal life support (ECLS) are at risk for hemolysis-related complications. Therefore, monitoring of free hemoglobin (fHb) levels is indicated. Conventional methods for fHb are laborious and not always available. Here we evaluated the suitability of the hemolysis-index (H-index), an internal quality control parameter of clinical chemistry platforms, as a clinical parameter for ECLS patients. Materials and methods The performance of the H-index assay was evaluated using standard procedures. Furthermore, H-index data from ECLS patients (n = 56) was analyzed retrospectively. Results The H-index significantly correlated with fHb and showed good analytical performance. During ECLS 19.6% of the patients had an H-index above 20 in at least 2 consecutive blood draws, indicating significant hemolysis. In the patients with clot formation in the pumphead the H-index peaked above 100. Visible clots at other locations did not always coincide with hemolysis. H-index peaks were more prevalent in patients that died during ECLS support. Conclusions We conclude that the H-index is a suitable and cost-efficient alternative for the conventional fHb analysis with good analytic performance. The H-index aids in the early detection of hemolysis in patients with ECLS. A repeated H-index>20 was a predictor of mortality. |
| Databáze: | OpenAIRE |
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