Abstract
The total pump head and the pressure difference are considered to be risk factors of hemolysis during peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, the cut-off values of these parameters are not determined. Between 2012 and 2015, peripheral VA-ECMO was used in 101 patients. Free plasma hemoglobin of more than 50mg/dL was defined as hemolysis. Of 101 VA-ECMO cases, hemolysis was observed in 27 patients (26.7%). Covariates were compared between hemolysis and non-hemolysis groups, and risks of hemolysis were analyzed. Compared to non-hemolysis group, hemolysis group had significantly higher total pump head (512.9±181.8mmHg, 333.4±120.1mmHg; p<0.0001) and lower negative pressure (-317.6±170.9mmHg, -156.7±108.0mmHg; p<0.0001). Total pump head of more than 430mmHg and negative pressure of less than -270mmHg were considered to be cut-off values by using receiver-operator curve. In addition, hemolysis group had a higher occurrence rate of acute kidney injury compared to non-hemolysis group (60%[14/23]vs. 13%[7/52]; p<0.0001), Therefore, avoidance of hemolysis is important under VA-ECMO support.
