Intraoperative Hemolysis Monitoring by Real-time Point-of-care in Patients Undergoing Cardiopulmonary Bypass in Cardiac Surgery: A Single-centre Prospective Observational Study

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-02-28 DOI:10.1053/j.jvca.2025.02.048

Lorenzo Schiavoni MD , Mariapia Stifano MD , Francesca La Verde MD , Alessandro Strumia MD , Annalaura Di Pumpo MD , Domenico Sarubbi MD , Stefano Rizzo MD , Maria Cristina Conti MD , Lara Mortini MD , Rita Cataldo MD , Fabio Costa MD , Giuseppe Pascarella MD , Alessandro Rita , Elena Casali , Felice Eugenio Agrò MD , Massimiliano Carassiti MD , Alessia Mattei MD

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Abstract

Objective

Hemolysis is a complication in surgical procedures requiring cardiopulmonary bypass (CPB). The primary aim of this study was to evaluate the effectiveness of the point-of-care device Hemcheck Helge V-Test, quantifying hemolysis during cardiac surgery with CPB.

Design

Prospective-observational study.

Setting

Single-center study.

Participants

Patients undergoing elective cardiac surgery with CPB.

Interventions

Blood samples of 78 patients were simultaneously collected during surgery at T0: pre-CPB; T1: at aorta clamping; T2: at 20 minutes after the CPB start; T3: at the end of CPB; and T4: at the end of surgery. Samples were analyzed by the Hemcheck Helge V-Test device, which offers a real-time assessment of hemolysis through the value of plasma-free hemoglobin (PfHb) expressed in mg/dL.

Measurements and Main Results

No case of hemolysis (PfHb ≥50 mg/dL) was recorded at T0. The results recorded median PfHb values at T0 = 0.5 (0-7.1) mg/dL, T1 = 3.75 (0-14.4) mg/dL; T2 = 8.25 (0.4-19.1) mg/dL, T3 = 27.5 (9.9-50) mg/dL, and T4 = 18.5 (2.4-41) mg/dL; for all T times, p-values were < 0.001. A statistically significant correlation was recorded between hemolysis values >50 mg/dL at T3 and CPB time >100 minutes (p < 0.05).

Conclusions

The use of Hemcheck Helge V-Test allows effective identification of hemolysis directly in the operating room, reducing wasted time for laboratory analyses. This could help the anesthesiologist, perfusionist, or cardiac surgeon address intraoperative hemolysis and its effects on organ function earlier and improve the postoperative course of patients undergoing cardiac surgery with CPB.

查看原文本刊更多论文

通过实时护理点对接受心肺搭桥术的心脏手术患者进行术中溶血监测：单中心前瞻性观察研究。

目的：溶血是体外循环（CPB）手术的并发症。本研究的主要目的是评估即时护理设备Hemcheck Helge V-Test的有效性，量化CPB心脏手术期间的溶血情况。设计：前瞻性观察性研究。设置：单中心研究。参与者：接受选择性CPB心脏手术的患者。干预措施：78例患者术中同时采血，时间为T0: cpb前；T1：主动脉夹持；T2: CPB开始后20分钟；T3: CPB结束时；T4：手术结束时。样品通过Hemcheck Helge V-Test设备进行分析，该设备通过以mg/dL表示的血浆游离血红蛋白（PfHb）值实时评估溶血情况。测量及主要结果：T0无溶血（PfHb≥50 mg/dL）记录。结果记录的PfHb中位值为T0 = 0.5 (0-7.1) mg/dL, T1 = 3.75 (0-14.4) mg/dL；T2 = 8.25 (0.4-19.1) mg/dL, T3 = 27.5 (9.9-50) mg/dL, T4 = 18.5 (2.4-41) mg/dL；在所有T次中，p值均< 0.001。T3时溶血值>50 mg/dL与CPB时间>100 min有统计学意义（p < 0.05）。结论：使用Hemcheck Helge V-Test可直接在手术室有效识别溶血，减少实验室分析浪费时间。这可以帮助麻醉师、灌注师或心脏外科医生更早地解决术中溶血及其对器官功能的影响，并改善心脏手术合并CPB患者的术后病程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.