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Hemolysis and Plasma Free Hemoglobin During Extracorporeal Membrane Oxygenation Support

From Clinical Implications to Laboratory Details. A Review

Dufour, Nicolas*; Radjou, Aguila*; Thuong, Marie*

doi: 10.1097/MAT.0000000000000974
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Venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) are lifesaving supports that are more and more frequently used in critically ill patients. Despite of major technological improvements observed during the last 20 years, ECMO-associated hemolysis is still a complication that may arise during such therapy. Hemolysis severity, directly appreciated by plasma free hemoglobin concentration, may be present with various intensity, from a nonalarming and tolerable hemolysis to a highly toxic one. Here, we propose a review dedicated to extracorporeal membrane oxygenation (ECMO)-associated hemolysis, with a particular emphasis on pathophysiology, prevalence, and clinical consequences of such complication. We also focus on laboratory assessment of hemolysis and on the limits that have to be known by clinicians to prevent and manage hemolytic events.

From the *Réanimation Médico-chirurgicale, Centre Hospitalier René Dubos, Pontoise, France.

Submitted for consideration November 2018; accepted for publication in revised form January 2019.

Disclosure: The authors have no conflicts of interest to report.

This work was performed within the scope of a postgraduate university degree funded by Centre Hospitalier René Dubos.

Dr. Dufour wrote the article with support from Drs. Radjou and Thuong.

Correspondence: Nicolas Dufour, Centre Hospitalier René Dubos, Pontoise, France. Email: nicolas.dufour@ght-novo.fr.

Copyright © 2019 by the American Society for Artificial Internal Organs