{"title":"体外膜氧合过程中碳氧血红蛋白和高铁血红蛋白水平与溶血的关系。","authors":"Tsubasa Yoshida, Satoshi Kimura, Takanobu Sakura, Tatsuhiko Shimizu, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tatsuo Iwasaki, Hiroshi Morimatsu","doi":"10.1177/03913988251326398","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Hemolysis, characterized by increased carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels, is a complication of extracorporeal membrane oxygenation (ECMO).</p><p><strong>Methods: </strong>This prospective single-center study aimed to investigate the correlation between COHb and MetHb levels and hemolysis during ECMO. This study included 32 patients requiring ECMO for circulatory or respiratory failure. Plasma-free hemoglobin (pfHb), COHb, and MetHb levels were measured simultaneously within 6 h of ECMO induction, daily during ECMO, within 6 h after decannulation, and 2 days after decannulation unless death occurred before. Patients were classified into hemolysis and non-hemolysis groups based on whether the maximum pfHb level during ECMO was ⩾50 mg/dL.</p><p><strong>Results: </strong>No significant difference in maximum COHb levels during ECMO (COHb<sub>ECMO</sub>) was observed between the hemolysis and non-hemolysis groups (2.15% [interquartile range (IQR) = 1.83, 2.60] vs 1.65% [IQR = 1.40, 2.10], <i>p</i> = 0.159). However, maximum MetHb levels during ECMO (MetHb<sub>ECMO</sub>) were significantly higher in the hemolysis group (1.35% [IQR = 1.12, 1.78] vs 1.10% [IQR = 0.90, 1.37], <i>p</i> = 0.045). The Spearman's correlation coefficients for COHb<sub>ECMO</sub> and MetHb<sub>ECMO</sub> were 0.39 (95% confidence interval [CI] = 0.456-0.649) and 0.66 (95% CI = 0.404-0.820), respectively.</p><p><strong>Conclusion: </strong>Elevated MetHb levels in patients undergoing ECMO may be associated with hemolysis.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988251326398"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of carboxyhemoglobin and methemoglobin levels with hemolysis during extracorporeal membrane oxygenation.\",\"authors\":\"Tsubasa Yoshida, Satoshi Kimura, Takanobu Sakura, Tatsuhiko Shimizu, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tatsuo Iwasaki, Hiroshi Morimatsu\",\"doi\":\"10.1177/03913988251326398\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Hemolysis, characterized by increased carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels, is a complication of extracorporeal membrane oxygenation (ECMO).</p><p><strong>Methods: </strong>This prospective single-center study aimed to investigate the correlation between COHb and MetHb levels and hemolysis during ECMO. This study included 32 patients requiring ECMO for circulatory or respiratory failure. Plasma-free hemoglobin (pfHb), COHb, and MetHb levels were measured simultaneously within 6 h of ECMO induction, daily during ECMO, within 6 h after decannulation, and 2 days after decannulation unless death occurred before. Patients were classified into hemolysis and non-hemolysis groups based on whether the maximum pfHb level during ECMO was ⩾50 mg/dL.</p><p><strong>Results: </strong>No significant difference in maximum COHb levels during ECMO (COHb<sub>ECMO</sub>) was observed between the hemolysis and non-hemolysis groups (2.15% [interquartile range (IQR) = 1.83, 2.60] vs 1.65% [IQR = 1.40, 2.10], <i>p</i> = 0.159). However, maximum MetHb levels during ECMO (MetHb<sub>ECMO</sub>) were significantly higher in the hemolysis group (1.35% [IQR = 1.12, 1.78] vs 1.10% [IQR = 0.90, 1.37], <i>p</i> = 0.045). The Spearman's correlation coefficients for COHb<sub>ECMO</sub> and MetHb<sub>ECMO</sub> were 0.39 (95% confidence interval [CI] = 0.456-0.649) and 0.66 (95% CI = 0.404-0.820), respectively.</p><p><strong>Conclusion: </strong>Elevated MetHb levels in patients undergoing ECMO may be associated with hemolysis.</p>\",\"PeriodicalId\":13932,\"journal\":{\"name\":\"International Journal of Artificial Organs\",\"volume\":\" \",\"pages\":\"3913988251326398\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-03-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Artificial Organs\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1177/03913988251326398\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Artificial Organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/03913988251326398","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
摘要
溶血是体外膜氧合（ECMO）的并发症，其特征是碳氧血红蛋白（COHb）和高铁血红蛋白（MetHb）水平升高。方法：本前瞻性单中心研究旨在探讨ECMO期间COHb和MetHb水平与溶血的相关性。本研究包括32例因循环或呼吸衰竭需要体外膜肺栓塞的患者。在ECMO诱导后6小时内、ECMO期间每天、脱管后6小时内和脱管后2天内同时测量血浆游离血红蛋白（pfHb）、COHb和MetHb水平，除非之前发生死亡。根据ECMO期间最大pfHb水平是否大于或等于50 mg/dL，将患者分为溶血组和非溶血组。结果：溶血组和非溶血组ECMO （COHbECMO）期间最大COHb水平差异无统计学意义（2.15%[四分位数范围(IQR) = 1.83, 2.60] vs 1.65% [IQR = 1.40, 2.10], p = 0.159）。然而，溶血组ECMO （MetHbECMO）期间MetHb的最高水平显著高于溶血组（1.35% [IQR = 1.12, 1.78] vs 1.10% [IQR = 0.90, 1.37], p = 0.045）。COHbECMO和MetHbECMO的Spearman相关系数分别为0.39（95%可信区间[CI] = 0.456-0.649）和0.66 （95% CI = 0.404-0.820）。结论：ECMO患者甲基苯丙胺水平升高可能与溶血有关。
Association of carboxyhemoglobin and methemoglobin levels with hemolysis during extracorporeal membrane oxygenation.
Introduction: Hemolysis, characterized by increased carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels, is a complication of extracorporeal membrane oxygenation (ECMO).
Methods: This prospective single-center study aimed to investigate the correlation between COHb and MetHb levels and hemolysis during ECMO. This study included 32 patients requiring ECMO for circulatory or respiratory failure. Plasma-free hemoglobin (pfHb), COHb, and MetHb levels were measured simultaneously within 6 h of ECMO induction, daily during ECMO, within 6 h after decannulation, and 2 days after decannulation unless death occurred before. Patients were classified into hemolysis and non-hemolysis groups based on whether the maximum pfHb level during ECMO was ⩾50 mg/dL.
Results: No significant difference in maximum COHb levels during ECMO (COHbECMO) was observed between the hemolysis and non-hemolysis groups (2.15% [interquartile range (IQR) = 1.83, 2.60] vs 1.65% [IQR = 1.40, 2.10], p = 0.159). However, maximum MetHb levels during ECMO (MetHbECMO) were significantly higher in the hemolysis group (1.35% [IQR = 1.12, 1.78] vs 1.10% [IQR = 0.90, 1.37], p = 0.045). The Spearman's correlation coefficients for COHbECMO and MetHbECMO were 0.39 (95% confidence interval [CI] = 0.456-0.649) and 0.66 (95% CI = 0.404-0.820), respectively.
Conclusion: Elevated MetHb levels in patients undergoing ECMO may be associated with hemolysis.
期刊介绍：
The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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