29, 14, 22
The circuit is routinely blamed for haemolysis the illness and the resuscitation caused. Take a full laboratory panel BEFORE the pump starts; without it every later value is read against the wrong comparison.
The three pre-cannulation clinical states compared with each other and with values on support
Lehle K, Lubnow M, Philipp A, Foltan M, Zeman F, Zausig Y, Lunz D, Schmid C, Muller T. Eur J Heart Fail 2017;19(S2):110-116. DOI 10.1002/ejhf.854
Daily plasma free haemoglobin, lactate and pH before and during support
Retrospective, single centre, cardiac population; not designed to test attribution
Pre-cannulation free haemoglobin 318 (138-586) versus 212 (107-439) versus 79 (53-232) mg/L across the three groups, p under 0.001. Free haemoglobin declined significantly within 24 hours ON support; implantation did not aggravate haemolysis but decreased it. Pre-cannulation free haemoglobin had no prognostic value on multivariable analysis; only a low pre-cannulation lactate predicted successful weaning (p under 0.0001) and hospital discharge (p=0.0028).
215 adults with cardiac failure on extracorporeal life support, in three groups: cannulated during ongoing CPR (n=110), after ROSC with sustained shock (n=45), severe shock without preceding resuscitation (n=60)