Introduction:

Hemolysis is a common complication of extracorporeal membrane oxygenation (ECMO). There are few data on whether carboxyhemoglobin (COHb), a potential marker of hemolysis, are elevated during ECMO support.

Methods:

We conducted a single-center, retrospective study comparing peak COHb levels of children pre-, during, and post-ECMO from January 2017 to August 2020.

Results:

There were 154 ECMO runs in 147 children (154 PICU admissions) included in the study. The median age was 3.5 (IQR 0.2, 39.2) months. Veno-arterial ECMO was the predominant mode: 146/154 (94.8%). Eighty-seven children (56.5%) underwent cardiac surgery. Peak COHb levels during ECMO were statistically significantly higher compared to pre ECMO (COHb 1.8% (IQR 1.4, 2.6) vs COHb 1.2% (IQR 0.7, 1.7), p < 0.001) and post ECMO (COHb 1.6% (IQR 1.3, 2.2), p = 0.009). Children with COHb ⩾2% were younger and had longer duration of ECMO support. Plasma hemoglobin weakly correlated with COHb level (r = 0.14; p = 0.04).

Conclusions:

Carboxyhemoglobin levels increased during ECMO support compared to the pre and post ECMO period. Younger age and longer ECMO duration were associated with COHb levels ⩾2%. Plasma hemoglobin weakly correlated with COHb level.

中文翻译：

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体外膜氧合支持期间儿童碳氧血红蛋白水平的回顾性研究

介绍：

溶血是体外膜肺氧合 (ECMO) 的常见并发症。关于碳氧血红蛋白 (COHb)（溶血的潜在标志物）在 ECMO 支持期间是否升高的数据很少。

方法：

我们进行了一项单中心回顾性研究，比较了 2017 年 1 月至 2020 年 8 月儿童在 ECMO 前、期间和后的 COHb 峰值水平。

结果：

该研究包括 147 名儿童（154 名 PICU 入院）的 154 次 ECMO 运行。中位年龄为 3.5 (IQR 0.2, 39.2) 个月。静脉-动脉 ECMO 是主要模式：146/154 (94.8%)。87 名儿童 (56.5%) 接受了心脏手术。与 ECMO 前 (COHb 1.8% (IQR 1.4, 2.6) 对比 COHb 1.2% (IQR 0.7, 1.7), p < 0.001) 和 ECMO 后 (COHb 1.6% (IQR 1.3, 2.2) ), p = 0.009)。COHb 2% 的儿童更年轻，ECMO 支持时间更长。血浆血红蛋白与 COHb 水平弱相关 ( r  = 0.14；p = 0.04)。

结论：

与 ECMO 前后相比，ECMO 支持期间的碳氧血红蛋白水平有所升高。年龄较小和 ECMO 持续时间较长与 COHb 水平相关 2%。血浆血红蛋白与 COHb 水平弱相关。