Hemolysis during long-term extracorporeal membrane oxygenation

Robin H Steinhorn, Barbara Isham-Schopf, Clark Smith, Thomas P. Green

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

We studied the cause of hemolysis during extracorporeal membrane oxygenation (ECMO) by monitoring hematologic and coagulation profiles in seven consecutive infants treated with this procedure. A constrained vortex pump was used in all patients, and the average duration of ECMO was 224±111 (SD) hours. In all patients, plasma free hemoglobin was low during the first 48 hours after the initiation of ECMO. Later, when visible clots appeared in the ECMO circuit, plasma hemoglobin progressively rose. A rise in the level of fibrin degradation products and a fall in the fibrinogen level were observed concurrently with a rise in the plasma hemoglobin level. After complete circuit changes in six patients, plasma free hemoglobin, fibrin split products, and fibrinogen all returned to baseline values. Neither circuit component changes nor exchange transfusion was effective in normalizing the levels of plasma free hemoglobin, fibrin split products, and fibrinogen. We conclude that when ECMO is administered for prolonged periods, circuit thrombosis occurs and hemolysis ensues. Additional studies are needed to assess the contribution of the constrained vortex pump to this process.

Original languageEnglish (US)
Pages (from-to)625-630
Number of pages6
JournalThe Journal of Pediatrics
Volume115
Issue number4
DOIs
StatePublished - 1989
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Steinhorn, R. H., Isham-Schopf, B., Smith, C., & Green, T. P. (1989). Hemolysis during long-term extracorporeal membrane oxygenation. The Journal of Pediatrics, 115(4), 625-630. https://doi.org/10.1016/S0022-3476(89)80299-9