29, 31, 68
The haemolysis-generating variable is not the pump's name or price but the pressure and geometry it works against. And there is no treatment for the finding — what a rising free haemoglobin changes is surveillance and circuit inspection, not a prescription.
Adult ECMO experience
Garg M. NeoReviews 2020;21(11):e728-e740. DOI 10.1542/neo.21-11-e728
Narrative review of haemolysis mechanism, risk factors and consequences
Narrative review; neonatal and paediatric; the pump-type direction is reported rather than independently analysed here
ELSO data indicate a significant INCREASE in intravascular haemolysis in neonates and children with centrifugal pumps compared with their use in adults — the opposite of the adult roller-versus-centrifugal direction. Stated risk factors: small cannula size, high negative inlet pressure in the pump head, thrombosis in the pump head and oxygenator. Haemolysis increases renal injury, direct hyperbilirubinaemia and thrombosis WITHOUT an increase in mortality, and is described as an unavoidable side effect of current ECMO technology for which there are no approved treatments or treatment guidelines.
Neonatal and paediatric ECMO