Clearance of severely elevated plasma free hemoglobin with total plasma exchange in a pediatric ECMO patient

Stephaine Houston; Shruti Patel; Aditya Badheka; Kathy Lee-Son

doi:10.1177/02676591211021946

Clearance of severely elevated plasma free hemoglobin with total plasma exchange in a pediatric ECMO patient

Perfusion. 2022 Jul;37(5):515-518. doi: 10.1177/02676591211021946. Epub 2021 May 31.

Authors

Stephaine Houston¹, Shruti Patel², Aditya Badheka², Kathy Lee-Son¹

Affiliations

¹ Division of Pediatric Nephrology, Stead Family Department of Pediatric, University of Iowa Children's Hospital, University of Iowa, Iowa, IA, USA.
² Division of Pediatric Critical Care, Stead Family Department of Pediatric, University of Iowa Children's Hospital, University of Iowa, Iowa, IA, USA.

PMID: 34058891
DOI: 10.1177/02676591211021946

Abstract

Extracorporeal membrane oxygenation (ECMO)-related hemolysis is common with reported incidence of 5%-18%. Plasma free hemoglobin (PFH) levels are used as a marker for hemolysis and elevated PFH is associated with acute kidney injury (AKI). Limited literature exists regarding treatment of severe hemolysis and clearance of PFH. We report 8-year-old male child on VA ECMO with severe hemolysis (PFH 895 mg/dL) and worsening AKI showing significant improvement in PFH after single volume exchange plasmapheresis with Fresh Frozen Plasma (FFP) performed in tandem via ECMO circuit.

Keywords: ECMO; acute kidney injury; hemolysis; pediatrics; plasma free hemoglobin; total plasma exchange.

Publication types

Case Reports

MeSH terms

Acute Kidney Injury*
Child
Extracorporeal Membrane Oxygenation*
Hemoglobins / analysis
Hemolysis
Humans
Male
Plasma Exchange
Plasmapheresis
Retrospective Studies

Substances

Hemoglobins