Lehle, Karla and Lubnow, Matthias and Philipp, Alois and Foltan, Maik and Zeman, Florian and Zausig, York and Lunz, Dirk and Schmid, Christof and Mueller, Thomas (2017) Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival? EUROPEAN JOURNAL OF HEART FAILURE, 19. pp. 110-116. ISSN 1388-9842, 1879-0844
Full text not available from this repository. (Request a copy)Abstract
Aims Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome. Methods and Results This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre-fHb) and during ECLS. CPR caused a pronounced increase in pre-fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre-fHb had no prognostic value for survival. Only a low pre-lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028). Conclusions CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre-fHb had no predictive value for survival.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CONVENTIONAL CARDIOPULMONARY-RESUSCITATION; NEURON-SPECIFIC ENOLASE; CARDIAC-ARREST; MEMBRANE-OXYGENATION; IMPACT; METAANALYSIS; HYPOTHERMIA; MORTALITY; ADULTS; PUMPS; hemolysis; plasma-free-hemoglobin; cardiogenic shock; resuscitation; ECPR; ECLS |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:10 |
| Last Modified: | 01 Mar 2019 11:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/949 |
Actions (login required)
 |
View Item |
