The meaning of a high plasma free haemoglobin: retrospective review of the prevalence of haemolysis and circuit thrombosis in an adult ECMO centre over 5 years.
Aims: In adults requiring extracorporeal membrane oxygenation (ECMO), we wanted to determine; i) the frequency of elevated plasma free haemoglobin (PFHb), ii) the reasons for circuit changes and iii) whether elevated PFHb was associated with higher in-hospital mortality. Materials and Methods: Patie...
| Publicado en: | Perfusion Vol. 31; no. 3; pp. 223 - 232 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications, Ltd.
Apr2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113645534&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113645534 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02676591 31J jtl: Perfusion issn: 02676591 maglogo: N pubinfo: dt: Apr2016 vid: 31 iid: 3 pid: 33180 pub: Sage Publications, Ltd. place: <Blank> artinfo: ui: 113645534 113645534 113645534 10.1177/0267659115595282 113645534 ppf: 223 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The meaning of a high plasma free haemoglobin: retrospective review of the prevalence of haemolysis and circuit thrombosis in an adult ECMO centre over 5 years. aug: au: Pan, K. C. McKenzie, D. P. Pellegrino, V. Murphy, D. Butt, W. affil: Intensive Care Unit, Alfred Hospital, Melbourne, VIC, Australia sug: subj: Extracorporeal Membrane Oxygenation Hemoglobins Hemolysis Thrombosis Hospital Mortality Human Prospective Studies Australia Data Analysis Software Kruskal-Wallis Test Post Hoc Analysis Mann-Whitney U Test APACHE (Acute Physiology and Chronic Health Evaluation) Severity of Illness Indices Chi Square Test Wilcoxon Signed Rank Test ab: Aims: In adults requiring extracorporeal membrane oxygenation (ECMO), we wanted to determine; i) the frequency of elevated plasma free haemoglobin (PFHb), ii) the reasons for circuit changes and iii) whether elevated PFHb was associated with higher in-hospital mortality. Materials and Methods: Patients requiring ECMO between January 2010 and August 2014 were identified from a prospectively collected ECMO database. Their scanned medical records and pathology results were reviewed. Relevant patient, biochemical and circuit data were collected on an Excel spreadsheet and analysed using Stata 13 (StataCorp, College Station, TX). The patients were analysed in three groups, depending on their peak PFHb during ECMO: ‘Normal PFHb’ (<0.1 g/L), ‘Low level PFHb’ (0.1 – 0.5 g/L), ‘High level PFHb’ (>0.5 g/L). Main Results: There were 184 ECMO runs (56 VV, 128 VA) – 61 ‘Normal PFHb’, 99 ‘Low level PFHb’, 24 ‘High level PFHb’. Circuit thrombosis (pump, oxygenator) or haemolysis requiring exchanges were significantly more common in VV ECMO compared to VA ECMO – 23.21% (13/56) vs. 0.78% (1/128), p<0.001. Elevated PFHb was associated with a longer duration of haemofiltration (p<0.001) and ECMO support (p<0.001). In-hospital mortality rates for the ‘Normal PFHb’, ‘Low level PFHb’ and ‘High level PFHb’ groups were 16.39% (10/61), 30.30% (30/99) and 37.50% (9/24), respectively, p=0.067. Conclusion: Elevated PFHb values during adult ECMO were common. Severe haemolysis or thrombosis requiring circuit changes were uncommon and occurred almost exclusively on VV ECMO. There was a non-statistically significant increase in in-hospital mortality with elevated PFHb and studies of larger registry data may clarify the prognostic value of PFHb in adult patients. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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