Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?
ABSTRACT Aims Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome. Methods...
Gespeichert in:
| Veröffentlicht in: | European journal of heart failure 2017-05, Vol.19 (S2), p.110-116 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 116 |
|---|---|
| container_issue | S2 |
| container_start_page | 110 |
| container_title | European journal of heart failure |
| container_volume | 19 |
| creator | Lehle, Karla Lubnow, Matthias Philipp, Alois Foltan, Maik Zeman, Florian Zausig, York Lunz, Dirk Schmid, Christof Müller, Thomas |
| description | ABSTRACT
Aims
Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome.
Methods and Results
This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre‐fHb) and during ECLS.
CPR caused a pronounced increase in pre‐fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre‐fHb had no prognostic value for survival. Only a low pre‐lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028).
Conclusions
CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre‐fHb had no predictive value for survival. |
| doi_str_mv | 10.1002/ejhf.854 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1895278501</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1895278501</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3554-862bfe0c6785255291f557f17ef17b27d0bbeff338a5042b15bcff4bdee6fa143</originalsourceid><addsrcrecordid>eNp1kc1O3DAURq2qqAwDUp-g8rKbgO3YE6cbhEbDn5Bg0a4j27nWmDpxaicM8yI8Lx4NhRWLK199Ojq68ofQd0pOKSHsDB7X9lQK_gXNqKzqgkjOv-a9lLKoJWeH6CilR0Jolelv6JBJXpGaLWbo5SHCk_LQG8DB4jV0wW-TS1j1Le5gVDp4Z7Ayrg272PV4UKODfkx448Y1Ni6ayasxxC22yvkpAk7TMIQ4QrtH4HmMyoSYM1Aee2ffkV9Y4U7FvxCxDTGn8cnlc86P0YFVPsHJ2ztHfy5Xv5fXxd391c3y4q4wpRC8kAumLRCzqKRgQrCaWiEqSyvIo1nVEq3B2rKUShDONBXaWMt1C7CwivJyjn7uvUMM_yZIY9O5ZMB71UOYUkNlLViWE_qBmhhSimCbIbp8-7ahpNm10OxaaHILGf3xZp10B-07-P_bM1DsgY3zsP1U1Kxury93wldiB5Xk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1895278501</pqid></control><display><type>article</type><title>Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Lehle, Karla ; Lubnow, Matthias ; Philipp, Alois ; Foltan, Maik ; Zeman, Florian ; Zausig, York ; Lunz, Dirk ; Schmid, Christof ; Müller, Thomas</creator><creatorcontrib>Lehle, Karla ; Lubnow, Matthias ; Philipp, Alois ; Foltan, Maik ; Zeman, Florian ; Zausig, York ; Lunz, Dirk ; Schmid, Christof ; Müller, Thomas</creatorcontrib><description>ABSTRACT
Aims
Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome.
Methods and Results
This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre‐fHb) and during ECLS.
CPR caused a pronounced increase in pre‐fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre‐fHb had no prognostic value for survival. Only a low pre‐lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028).
Conclusions
CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre‐fHb had no predictive value for survival.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1002/ejhf.854</identifier><identifier>PMID: 28470926</identifier><language>eng</language><publisher>Oxford, UK: John Wiley & Sons, Ltd</publisher><subject>Acidosis - blood ; Acidosis - epidemiology ; Acidosis - etiology ; Aged ; Anemia, Hemolytic - blood ; Anemia, Hemolytic - epidemiology ; Anemia, Hemolytic - etiology ; cardiogenic shock ; ECLS ; ECPR ; Extracorporeal Membrane Oxygenation - adverse effects ; Female ; Germany - epidemiology ; Heart Failure - therapy ; Hemoglobins - metabolism ; Hemolysis ; Humans ; Male ; Middle Aged ; plasma‐free‐hemoglobin ; Prevalence ; Prognosis ; resuscitation ; Retrospective Studies</subject><ispartof>European journal of heart failure, 2017-05, Vol.19 (S2), p.110-116</ispartof><rights>2017 The Authors. © 2017 European Society of Cardiology</rights><rights>2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3554-862bfe0c6785255291f557f17ef17b27d0bbeff338a5042b15bcff4bdee6fa143</citedby><cites>FETCH-LOGICAL-c3554-862bfe0c6785255291f557f17ef17b27d0bbeff338a5042b15bcff4bdee6fa143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejhf.854$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejhf.854$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46388,46812</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28470926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lehle, Karla</creatorcontrib><creatorcontrib>Lubnow, Matthias</creatorcontrib><creatorcontrib>Philipp, Alois</creatorcontrib><creatorcontrib>Foltan, Maik</creatorcontrib><creatorcontrib>Zeman, Florian</creatorcontrib><creatorcontrib>Zausig, York</creatorcontrib><creatorcontrib>Lunz, Dirk</creatorcontrib><creatorcontrib>Schmid, Christof</creatorcontrib><creatorcontrib>Müller, Thomas</creatorcontrib><title>Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?</title><title>European journal of heart failure</title><addtitle>Eur J Heart Fail</addtitle><description>ABSTRACT
Aims
Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome.
Methods and Results
This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre‐fHb) and during ECLS.
CPR caused a pronounced increase in pre‐fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre‐fHb had no prognostic value for survival. Only a low pre‐lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028).
Conclusions
CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre‐fHb had no predictive value for survival.</description><subject>Acidosis - blood</subject><subject>Acidosis - epidemiology</subject><subject>Acidosis - etiology</subject><subject>Aged</subject><subject>Anemia, Hemolytic - blood</subject><subject>Anemia, Hemolytic - epidemiology</subject><subject>Anemia, Hemolytic - etiology</subject><subject>cardiogenic shock</subject><subject>ECLS</subject><subject>ECPR</subject><subject>Extracorporeal Membrane Oxygenation - adverse effects</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Heart Failure - therapy</subject><subject>Hemoglobins - metabolism</subject><subject>Hemolysis</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>plasma‐free‐hemoglobin</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>resuscitation</subject><subject>Retrospective Studies</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1O3DAURq2qqAwDUp-g8rKbgO3YE6cbhEbDn5Bg0a4j27nWmDpxaicM8yI8Lx4NhRWLK199Ojq68ofQd0pOKSHsDB7X9lQK_gXNqKzqgkjOv-a9lLKoJWeH6CilR0Jolelv6JBJXpGaLWbo5SHCk_LQG8DB4jV0wW-TS1j1Le5gVDp4Z7Ayrg272PV4UKODfkx448Y1Ni6ayasxxC22yvkpAk7TMIQ4QrtH4HmMyoSYM1Aee2ffkV9Y4U7FvxCxDTGn8cnlc86P0YFVPsHJ2ztHfy5Xv5fXxd391c3y4q4wpRC8kAumLRCzqKRgQrCaWiEqSyvIo1nVEq3B2rKUShDONBXaWMt1C7CwivJyjn7uvUMM_yZIY9O5ZMB71UOYUkNlLViWE_qBmhhSimCbIbp8-7ahpNm10OxaaHILGf3xZp10B-07-P_bM1DsgY3zsP1U1Kxury93wldiB5Xk</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Lehle, Karla</creator><creator>Lubnow, Matthias</creator><creator>Philipp, Alois</creator><creator>Foltan, Maik</creator><creator>Zeman, Florian</creator><creator>Zausig, York</creator><creator>Lunz, Dirk</creator><creator>Schmid, Christof</creator><creator>Müller, Thomas</creator><general>John Wiley & Sons, Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201705</creationdate><title>Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?</title><author>Lehle, Karla ; Lubnow, Matthias ; Philipp, Alois ; Foltan, Maik ; Zeman, Florian ; Zausig, York ; Lunz, Dirk ; Schmid, Christof ; Müller, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3554-862bfe0c6785255291f557f17ef17b27d0bbeff338a5042b15bcff4bdee6fa143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acidosis - blood</topic><topic>Acidosis - epidemiology</topic><topic>Acidosis - etiology</topic><topic>Aged</topic><topic>Anemia, Hemolytic - blood</topic><topic>Anemia, Hemolytic - epidemiology</topic><topic>Anemia, Hemolytic - etiology</topic><topic>cardiogenic shock</topic><topic>ECLS</topic><topic>ECPR</topic><topic>Extracorporeal Membrane Oxygenation - adverse effects</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Heart Failure - therapy</topic><topic>Hemoglobins - metabolism</topic><topic>Hemolysis</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>plasma‐free‐hemoglobin</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>resuscitation</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lehle, Karla</creatorcontrib><creatorcontrib>Lubnow, Matthias</creatorcontrib><creatorcontrib>Philipp, Alois</creatorcontrib><creatorcontrib>Foltan, Maik</creatorcontrib><creatorcontrib>Zeman, Florian</creatorcontrib><creatorcontrib>Zausig, York</creatorcontrib><creatorcontrib>Lunz, Dirk</creatorcontrib><creatorcontrib>Schmid, Christof</creatorcontrib><creatorcontrib>Müller, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lehle, Karla</au><au>Lubnow, Matthias</au><au>Philipp, Alois</au><au>Foltan, Maik</au><au>Zeman, Florian</au><au>Zausig, York</au><au>Lunz, Dirk</au><au>Schmid, Christof</au><au>Müller, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?</atitle><jtitle>European journal of heart failure</jtitle><addtitle>Eur J Heart Fail</addtitle><date>2017-05</date><risdate>2017</risdate><volume>19</volume><issue>S2</issue><spage>110</spage><epage>116</epage><pages>110-116</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>ABSTRACT
Aims
Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome.
Methods and Results
This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre‐fHb) and during ECLS.
CPR caused a pronounced increase in pre‐fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre‐fHb had no prognostic value for survival. Only a low pre‐lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028).
Conclusions
CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre‐fHb had no predictive value for survival.</abstract><cop>Oxford, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>28470926</pmid><doi>10.1002/ejhf.854</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1388-9842 |
| ispartof | European journal of heart failure, 2017-05, Vol.19 (S2), p.110-116 |
| issn | 1388-9842 1879-0844 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1895278501 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Acidosis - blood Acidosis - epidemiology Acidosis - etiology Aged Anemia, Hemolytic - blood Anemia, Hemolytic - epidemiology Anemia, Hemolytic - etiology cardiogenic shock ECLS ECPR Extracorporeal Membrane Oxygenation - adverse effects Female Germany - epidemiology Heart Failure - therapy Hemoglobins - metabolism Hemolysis Humans Male Middle Aged plasma‐free‐hemoglobin Prevalence Prognosis resuscitation Retrospective Studies |
| title | Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T00%3A21%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20hemolysis%20and%20metabolic%20acidosis%20in%20patients%20with%20circulatory%20failure%20supported%20with%20extracorporeal%20life%20support:%20a%20marker%20for%20survival?&rft.jtitle=European%20journal%20of%20heart%20failure&rft.au=Lehle,%20Karla&rft.date=2017-05&rft.volume=19&rft.issue=S2&rft.spage=110&rft.epage=116&rft.pages=110-116&rft.issn=1388-9842&rft.eissn=1879-0844&rft_id=info:doi/10.1002/ejhf.854&rft_dat=%3Cproquest_cross%3E1895278501%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1895278501&rft_id=info:pmid/28470926&rfr_iscdi=true |