Table 3.
ECMO System Setup and Management by Peak Level of Hemolysis
| Peak Hemolysis |
||||||
|---|---|---|---|---|---|---|
| Variablea | None (N = 4) |
Mild (N = 67) |
Moderate (N = 51) |
Severe (N = 94) |
P-value | |
| ECMO system Setup | ||||||
| Mode of ECMO | 0.921b | |||||
| Venoarterial | 3 (1.6%) | 56 (29.9%) | 50 (26.7%) | 78 (41.7%) | ||
| Venovenous | 1 (3.4%) | 11 (37.9%) | 1 (3.4%) | 16 (55.2%) | ||
| Type of Pump | 0.047b | |||||
| Roller Head | 0 (0.0%) | 0 (0.0%) | 7 (46.7%) | 8 (53.3%) | ||
| Centrifugal | 4 (2.0%) | 67 (33.3%) | 44 (21.9%) | 86 (42.8%) | ||
| Setup includes bladder / venous reservoir | 4 (2.9%) | 39 (27.9%) | 31 (22.1%) | 66 (47.1%) | 0.290b | |
| Oxygenator biocompatibility coating | 4 (1.9%) | 64 (30.8%) | 49 (23.6%) | 91 (43.8%) | 0.778b | |
| Circuit tubing biocompatibility coating | 4 (3.2%) | 33 (26.8%) | 28 (22.8%) | 58 (47.1%) | 0.346b | |
| Method for priming the circuit | 0.009b | |||||
| Non-blood (clear) | 1 (5.6%) | 10 (55.6%) | 3 (16.7%) | 4 (22.2%) | ||
| Blood | 3 (1.5%) | 57 (28.8%) | 48 (24.2%) | 90 (45.5%) | ||
| Heparin bolus for cannulation | 4 (2.2%) | 61 (33.3%) | 39 (21.3%) | 79 (43.2%) | 0.201b | |
| Heparin bolus dose (IU/kg)c | 50.0 [50.0, 75.0] | 100.0 [50.0, 100.0] | 75.0 [1.0, 100.0] | 89.0 [50.0, 100.0] | 0.420d | |
| ECMO Managemente | ||||||
| Plasmapheresis | 0 (0.0%) | 4 (21.1%) | 5 (26.3%) | 10 (52.6%) | 0.248b | |
| In-line hemofiltration | 1 (1.5%) | 7 (10.8%) | 17 (26.2%) | 40 (61.5%) | <.001b | |
| Continuous renal replacement therapy | 0 (0.0%) | 10 (15.9%) | 16 (25.4%) | 37 (58.7%) | <.001b | |
| Therapeutic hypothermia | 0 (0.0%) | 3 (30.0%) | 2 (20.0%) | 5 (50.0%) | 0.687b | |
| Mean daily ECMO flow rate (mL/kg/min) | 62.3 [56.4, 88.0] | 89.2 [71.6, 103.9] | 93.3 [79.3, 112.5] | 102.8 [89.1, 120.5] | <.001d | |
| Mean daily RBC transfusion (mL/kg) | 12.9 [10.8, 15.2] | 27.3 [12.6, 58.9] | 35.5 [23.4, 57.3] | 35.8 [26.8, 58.7] | 0.007d | |
| Mean daily heparin dose (units/kg/min) | 0.4 [0.3, 0.5] | 0.3 [0.2, 0.4] | 0.3 [0.2, 0.5] | 0.4 [0.3, 0.6] | <.001d | |
| Mean daily platelet transfusion (mL/kg) | 3.1 [2.2, 3.9] | 8.7 [4.6, 14.6] | 16.2 [11.7, 23.8] | 19.8 [12.6, 28.3] | <.001d | |
| Mean daily plasma transfusion (mL/kg) | 6.4 [2.7, 9.0] | 5.3 [1.3, 14.7] | 8.7 [3.0, 17.9] | 8.8 [5.0, 16.4] | 0.010d | |
a
Variables reported had no missing values.
b
Cochran-Armitage trend test.
c
Heparin bolus dose (IU/kg) is summarized only for those who receive heparin.
d
Jonckheere-Terpstra test.
e
A limitation is that the timing of intervention in relation to hemolysis is not considered.