Pulse Oximetry Is Unreliable in Patients on Veno-Venous Extracorporeal Membrane Oxygenation Caused by Unrecognized Carboxyhemoglobinemia

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Saira NisarNimesh S Shah

Abstract

Continuous bedside pulse oximetry (SpO2) is universally used to monitor oxygenation for patients supported on veno-venous extracorporeal membrane oxygenation (VV-ECMO). Yet, elevated carboxyhemoglobin (COHb), a known event in VV-ECMO, diminishes the reliability of SpO2. This retrospective cohort study aims to assess the accuracy of SpO2 compared with oxyhemoglobin (SaO2) and quantify COHb levels by co-oximetry in the VV-ECMO population. Forty patients on VV_ECMO from 2012 to 2017 underwent 1,119 simultaneous SaO2 and SpO2 measurements. Most patients were male (60%) with average age of 46 years. SpO2 overestimated SaO2 values by 2.35% at time of cannulation and 0.0061% for each additional hour on VV-ECMO (p < 0.0001). Twenty-nine (72.5%) patients developed elevated COHb (>3% of hemoglobin saturation) at least once during VV-ECMO support and 602 (40.2%) arterial blood gases yielded elevated COHb levels. Mean duration for ECMO with elevated COHb was 244 hours compared with 98 hours in patients without (p < 0.0048). Patients who developed COHb were younger (mean age 40 vs. 55 years, p < 0.024) and had single-site double-lumen cannulation (odds ratio = 4.5, p = 0.23). At time of cannulation, mean COHb was 2.18% and increased by 0.00...Continue Reading

References

Aug 1, 1976·The Annals of Thoracic Surgery·V A Subramanian, R L Berger
Oct 1, 1989·The Journal of Pediatrics·R H SteinhornT P Green
Jun 2, 2001·Journal of the Royal Society of Medicine·I Blumenthal
Aug 22, 2003·Critical Care : the Official Journal of the Critical Care Forum·Gavin D PerkinsFang Gao
Aug 16, 2005·American Journal of Physiology. Lung Cellular and Molecular Physiology·Hiroshi MorimatsuKiyoshi Morita
Jun 15, 2007·Critical Care Medicine·Daniel D MelleyTimothy W Evans
Nov 27, 2008·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Greet HermansBart Meyns
Nov 18, 2011·The New England Journal of Medicine·Daniel Brodie, Matthew Bacchetta
Jan 10, 2012·International Journal of Critical Illness and Injury Science·Ravi S Tripathi, Thomas J Papadimos
Jan 13, 2012·Critical Care : the Official Journal of the Critical Care Forum·Andreas S FazekasGeorg-Christian Funk
Feb 27, 2013·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Loïc ChimotYves Le Tulzo
Apr 16, 2013·Intensive Care Medicine·Antoine KimmounBruno Levy
Apr 30, 2015·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Andrea MontisciFederico Pappalardo
Mar 5, 2016·Intensive Care Medicine·Christian KaragiannidisWolfram Windisch
May 24, 2018·The New England Journal of Medicine·Alain CombesUNKNOWN EOLIA Trial Group, REVA, and ECMONet

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