Carboxyhemoglobin predicts oxygenator performance and imminent oxygenator change in extracorporeal membrane oxygenation.
Blood gas analysis
Co-oximetry
Coagulation
Hemolysis
Surveillance
Thrombosis
Journal
Intensive care medicine experimental
ISSN: 2197-425X
Titre abrégé: Intensive Care Med Exp
Pays: Germany
ID NLM: 101645149
Informations de publication
Date de publication:
24 Apr 2024
24 Apr 2024
Historique:
received:
05
02
2024
accepted:
17
04
2024
medline:
24
4
2024
pubmed:
24
4
2024
entrez:
24
4
2024
Statut:
epublish
Résumé
The continuous exposure of blood to a non-biological surface during extracorporeal membrane oxygenation (ECMO) may lead to progressive thrombus formation in the oxygenator, hemolysis and consequently impaired gas exchange. In most centers oxygenator performance is monitored only on a once daily basis. Carboxyhemoglobin (COHb) is generated upon red cell lysis and is routinely measured with any co-oximetry performed to surveille gas exchange and acid-base homeostasis every couple of hours. This retrospective cohort study aims to evaluate COHb in the arterial blood gas as a novel marker of oxygenator dysfunction and its predictive value for imminent oxygenator change. Out of the 484 screened patients on ECMO 89, cumulatively requiring 116 oxygenator changes within 1833 patient days, including 19,692 arterial COHb measurements were analyzed. Higher COHb levels were associated with lower post-oxygenator pO COHb correlates with oxygenator performance and can be predictive of imminent oxygenator change. Therefore, longitudinal measurements of COHb in clinical routine might be a cheap and more granular candidate for ECMO surveillance that should be further analyzed in a controlled prospective trial design.
Sections du résumé
BACKGROUND
BACKGROUND
The continuous exposure of blood to a non-biological surface during extracorporeal membrane oxygenation (ECMO) may lead to progressive thrombus formation in the oxygenator, hemolysis and consequently impaired gas exchange. In most centers oxygenator performance is monitored only on a once daily basis. Carboxyhemoglobin (COHb) is generated upon red cell lysis and is routinely measured with any co-oximetry performed to surveille gas exchange and acid-base homeostasis every couple of hours. This retrospective cohort study aims to evaluate COHb in the arterial blood gas as a novel marker of oxygenator dysfunction and its predictive value for imminent oxygenator change.
RESULTS
RESULTS
Out of the 484 screened patients on ECMO 89, cumulatively requiring 116 oxygenator changes within 1833 patient days, including 19,692 arterial COHb measurements were analyzed. Higher COHb levels were associated with lower post-oxygenator pO
CONCLUSION
CONCLUSIONS
COHb correlates with oxygenator performance and can be predictive of imminent oxygenator change. Therefore, longitudinal measurements of COHb in clinical routine might be a cheap and more granular candidate for ECMO surveillance that should be further analyzed in a controlled prospective trial design.
Identifiants
pubmed: 38656714
doi: 10.1186/s40635-024-00626-7
pii: 10.1186/s40635-024-00626-7
doi:
Types de publication
Journal Article
Langues
eng
Pagination
41Investigateurs
Eva-Maria Kleinert
(EM)
Daniel Andrea Hofmaenner
(DA)
Mattia M Müller
(MM)
Christoph Camille Ganter
(CC)
Tobias Welte
(T)
Thorben Pape
(T)
Ann-Kathrin Rath
(AK)
Bahar Nalbant
(B)
Jannik Ruwisch
(J)
Christian Putensen
(C)
Konrad Peukert
(K)
Andrea Sauer
(A)
Lennart Wild
(L)
Informations de copyright
© 2024. The Author(s).
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