Predictive Potential of ECMO Blood Flow for Hemolysis and Outcome of Patients with Severe ARDS

Bünger V, Russ M, Kuebler WM, Menk M, Weber-Carstens S, Graw JA (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Journal of Clinical Medicine MDPI

Book Volume: 14

Article Number: 140

Journal Issue: 1

DOI: 10.3390/jcm14010140

Abstract

Background: Treatment with veno-venous extracorporeal membrane oxygenation (VV ECMO) has become a frequently considered rescue therapy in patients with severe acute respiratory distress syndrome (ARDS). Hemolysis is a common complication in patients treated with ECMO. Currently, it is unclear whether increased ECMO blood flow (Q̇EC) contributes to mortality and might be associated with increased hemolysis. Methods: A total of 441 patients with ARDS and VV ECMO, treated in a tertiary ARDS center, were included. The Q̇EC value for a significant increase in ICU mortality was determined by binary recursive partitioning. Linear regression analysis was performed to analyze a correlation between mean Q̇EC and mean plasma concentrations of cell-free hemoglobin (CFH). Results: A Q̇EC of 4 L/min divided the cohort into two groups with significantly different ICU mortality (Q̇EC ≤ 4 L/min: 39.3% (n = 300) versus Q̇EC > 4 L/min: 71.6% (n = 141), p < 0.001). Patients with Q̇EC > 4 L/min had a higher 28-day mortality. Furthermore, a higher mean Q̇EC was associated with increased CFH and decreased haptoglobin plasma concentrations. Conclusion: In patients with ARDS and VV ECMO, a mean Q̇EC > 4 L/min is associated with increased mortality, increased CFH and decreased haptoglobin plasma concentrations. Whether increased hemolysis determines the poorer outcome associated with higher Q̇EC should be the subject of future research.

Involved external institutions

Charité - Universitätsmedizin Berlin

Germany (DE)

How to cite

APA:

Bünger, V., Russ, M., Kuebler, W.M., Menk, M., Weber-Carstens, S., & Graw, J.A. (2025). Predictive Potential of ECMO Blood Flow for Hemolysis and Outcome of Patients with Severe ARDS. Journal of Clinical Medicine, 14(1). https://doi.org/10.3390/jcm14010140

MLA:

Bünger, Victoria, et al. "Predictive Potential of ECMO Blood Flow for Hemolysis and Outcome of Patients with Severe ARDS." Journal of Clinical Medicine 14.1 (2025).

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