Hemolysis in pediatric patients receiving centrifugal-pump extracorporeal membrane oxygenation: prevalence, risk factors, and outcomes

Critical Care Medicine
Song LouWarwick Butt

Abstract

To explore the prevalence and risk factors for hemolysis in children receiving extracorporeal membrane oxygenation and examine the relationship between hemolysis and adverse outcomes. Retrospective, single-center study. Tertiary PICU. Two hundred seven children receiving extracorporeal membrane oxygenation. None. Plasma-free hemoglobin was tested daily and hemolysis was diagnosed based on peak plasma-free hemoglobin as mild (< 0.5 g/L), moderate (0.5-1.0 g/L), or severe (> 1.0 g/L). Gender, age, weight, diagnosis, oxygenator type, cannulation site, mean venous inlet pressure, mean pump speed, mean flow, and visible clots in the extracorporeal membrane oxygenation circuit were entered into the ordered logistic regression model to identify risk factors of hemolysis. Complications and clinical outcomes were compared across four hemolysis groups. Of the 207 patients, 69 patients (33.3%; 95% CI, 27.0-40.2%) did not have hemolysis, 98 patients (47.3%; 95% CI, 40.4-54.4%) had mild hemolysis, 26 patients (12.5%; 95% CI, 8.4-17.9%) had moderate hemolysis, and 14 patients (6.8%; 95% CI, 3.7-11.1%) had severe hemolysis with a median peak plasma-free hemoglobin of 1.51 g/L (1.18-2.05 g/L). The independent risk factors for hemolysis during ...Continue Reading

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