Original ArticlePlasma Free Hemoglobin Is a Predictor of Acute Renal Failure During Adult Venous-Arterial Extracorporeal Membrane Oxygenation Support
Section snippets
Patients
Medical data of consecutive adult patients (≥18 years) with cardiac diseases and who required VA ECMO support between December 2010 and June 2015 in the Fuwai Hospital were retrospectively collected. Inclusion criteria included age≥18 years, sufficient data of PFHb and serum creatinine (SCr), and every patient with 1 ECMO run. Patients with history of kidney diseases were excluded. The authors’ institutional review board exempted this retrospective study from full review because there was no
Results
From December 2010 to June 2015 in Fuwai Hospital, 84 adult patients (age, 48.14±13.86 years; weight, 65.39±13.17 kg; male/female, 66/18) supported by VA ECMO with sufficient PFHb data were included in this retrospective study. One patient with missing PFHB was excluded. Indications of VA ECMO were found in 28 (33.3%) patients after heart transplantation, 51 (60.7%) patients after other cardiac surgery, and 5 (6%) patients with medical heart failure. The mean ECMO duration was 126.28±60.05
Discussion
Although ECMO increasingly has been used in critically ill patients with severe cardiopulmonary failure, the outcome of ECMO support has not been satisfactory. ARF as a risk factor of mortality is a severe complication during ECMO support.1 Early recognized risk factors for ARF and preventing ARF may decrease mortality of ECMO support. The initial pump speed of ECMO was a risk factor for AKI, and the red cell distribution width was a risk factor for stage 3 AKI in adult patients receiving ECMO.2
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2019, BurnsCitation Excerpt :MV and VILI may not only affect hemodynamics and pulmonary function, but may also lead to systemic inflammation via the release of inflammatory cytokines. Additionally, generation of plasma-free hemoglobin may cause renal tubular injury during ECMO treatment [72–74]. The latter factors may explain the higher glomerular and proximal convoluted tubular injury in the Hemo group, in which most animals had oliguria and pigmenturia.