Circuit Oxygenator Contributes to Extracorporeal Membrane Oxygenation-Induced Hemolysis

Duane C. Williams, Jennifer L. Turi, Christoph P. Hornik, Desiree K. Bonadonna, Walter L. Williford, Richard J. Walczak, Kevin M. Watt, Ira M. Cheifetz

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Hemolysis can occur as a consequence of extracorporeal membrane oxygenation (ECMO) and is associated with increased mortality and morbidity. Shear stress generated by flow through the circuit and oxygenator is believed to cause ECMO-induced hemolysis. We hypothesize that either a smaller dimension oxygenator or an in-line hemofilter will increase ECMO-associated hemolysis. Circuits were configured with a Quadrox-D Adult oxygenator (surface area 1.8 m2), Quadrox-iD Pediatric oxygenator (surface area 0.8 m2), or Quadrox-D Adult oxygenator with an in-line hemofilter (N = 4) and ran for 6 hours. Samples were collected hourly from the ECMO circuit and a time-based hemolysis control. Plasma hemoglobin levels were assayed. Circuit-induced hemolysis at each time point was defined as the change in plasma hemoglobin standardized to the time-based hemolysis control. Plasma hemoglobin increased with the use of the smaller dimension pediatric oxygenator as compared with the adult oxygenator when controlling for ECMO run time (p = 0.02). Furthermore, there was a greater pressure gradient with the smaller dimension pediatric oxygenator (p < 0.05). Plasma hemoglobin did not change with the addition of the in-line hemofilter. The use of a smaller dimension pediatric oxygenator resulted in greater hemolysis and a higher pressure gradient. This may indicate that the increased shear forces augment ECMO-induced hemolysis.

Original languageEnglish (US)
Pages (from-to)190-195
Number of pages6
JournalASAIO Journal
Volume61
Issue number2
DOIs
StatePublished - Jul 21 2015

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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  • Cite this

    Williams, D. C., Turi, J. L., Hornik, C. P., Bonadonna, D. K., Williford, W. L., Walczak, R. J., Watt, K. M., & Cheifetz, I. M. (2015). Circuit Oxygenator Contributes to Extracorporeal Membrane Oxygenation-Induced Hemolysis. ASAIO Journal, 61(2), 190-195. https://doi.org/10.1097/MAT.0000000000000173