AUTHOR=Cousin Vladimir L. , Giraud Raphaël , Assouline Benjamin , Silva Ivo Neto , Bendjelid Karim 

TITLE=Use of Carboxyhemoglobin as an Early Sign of Oxygenator Dysfunction in Patients Supported by Extracorporeal Membrane Oxygenation

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.893642

DOI=10.3389/fmed.2022.893642

ISSN=2296-858X

ABSTRACT=<sec><title>Introduction</title><p>Plasma free hemoglobin is the gold standard for monitoring hemolysis in extracorporeal membrane oxygenation (ECMO) but its routine use has some limitations. Carboxyhemoglobin (HbCO) is also a marker of intravascular hemolysis. We aimed to investigate HbCO as a marker of both hemolysis and oxygenator dysfunction in patients supported by ECMO.</p></sec><sec><title>Methods</title><p>Retrospective analysis of patients on ECMO in an adult ICU in a tertiary hospital. HbCO was recorded every 6 h in the 48 h before and after oxygenator change in adult patients on ECMO support with an oxygenator dysfunction and replacement.</p></sec><sec><title>Results</title><p>The investigation of 27 oxygenators replacements in 19 patients demonstrated that HbCO values progressively increased over time and then significantly decreased after oxygenator change. Median oxygenator lifespan was 14 days [interquartile range (IQR) 8–21] and there was no correlation between HbCO and oxygenator lifespan [Spearman coefficient 0.23 (<italic>p</italic> = 0.23)]. HbCO values at oxygenator change [HbCO median 2.7 (IQR 2.5–3.5)] were significantly higher than the HbCO values 1 week before [HbCO median 2.07 (IQR 1.86–2.8)] (<italic>p</italic> value &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>Our data highlight the potential role of HbCO as a novel marker for ECMO oxygenator dysfunction.</p></sec>