• Lin Lyu, Long Cun C Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Acad, Feilong Hei, Bingyang Ji, Jinping Liu, Kun Yu, Liang Chen, Jingxin Yao, Qiang Hu, Jinxiao Hu, and Guodong Gao.
• Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
• J. Cardiothorac. Vasc. Anesth. 2016 Aug 1; 30 (4): 891-5.

ObjectiveHemolysis is a common and severe complication during extracorporeal membrane oxygenation (ECMO). Increased plasma free hemoglobin (PFHb) is related to renal injury. The aim of this study was to investigate whether increased PFHb during adult venous-arterial ECMO was associated with acute renal failure (ARF).DesignA retrospective, observational, single-center study.SettingFuwai Hospital in Beijing, China.ParticipantsThe study comprised 84 venous-arterial ECMO patients.InterventionsNone.Measurements And Main ResultsA total of 84 consecutive adult patients (≥18 years) with cardiac diseases requiring venous-arterial ECMO support were studied retrospectively. Demographics of patients, clinical and ECMO characteristics, and PFHb level were collected within the first 3 days after ECMO. ARF was defined as a≥300% rise in serum creatinine from baseline or application of dialysis. Repeated measurement analysis of variance revealed that the main effect for the non-ARF group and ARF group in PFHb (p = 0.002) was significant. A significant main effect for time points (p<0.001) and time×group interaction (p = 0.014) in PFHb was obtained. In a multiple logistic regression model, peak PFHb during ECMO (odds ratio 1.052, 95% confidence interval 1.016-1.089, p = 0.005) was a risk factor for ARF during ECMO and patients who underwent heart transplantation (odds ratio 0.240, 95% confidence interval 0.060-0.964, p = 0.044) experienced less ARF. There was a linear correlation between peak serum creatinine and peak PFHb (Spearman's r = 0.223, p = 0.042).ConclusionsIncreased PFHb is a predictor of ARF among adult patients on venous-arterial ECMO support.Copyright © 2016 Elsevier Inc. All rights reserved.

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