Carboxyhemoglobin and Methemoglobin as Biomarkers of Hemolysis and Mortality in Acute Respiratory Distress Syndrome Treated by Veno-Venous Extracorporeal Membrane Oxygenation
Authors' conclusion
In patients with ARDS and ECMO, Met-Hb plasma concentrations were independently associated with hemolytic events. Both, mean CO-Hb and Met-Hb levels were associated with ICU mortality.
Study context
- Population
- Patients with acute respiratory distress syndrome (ARDS) on veno-venous extracorporeal membrane oxygenation (ECMO) at a tertiary ARDS referral center
- Participants
- 435 patients
- Exposure
- Carboxyhemoglobin (CO-Hb) and methemoglobin (Met-Hb) as markers of hemolytic events and intensive care unit (ICU) mortality
- Outcome
- Hemolytic events (cell-free hemoglobin (CFH) >50mg/dl) and ICU mortality associated with CO-Hb and Met-Hb
Methodological detailssingle tertiary ARDS referral centre
- Single tertiary ARDS referral centre
Main finding
As reported in the abstract
Estimate (95% CI)P value
Met-Hbhemolytic events; multivariable model
aOR 2.99(2.19–4.10)
P < 0.001Mean CO-HbICU mortality
OR 2.03(1.60–2.61)
P < 0.001Mean Met-HbICU mortality
OR 2.78(1.59–5.09)
P < 0.001- Met-Hb cutoff with 90% specificity for hemolytic event
- 1.55%
- Mortality cutoff, mean CO-Hb
- 2%
- Mortality cutoff, mean Met-Hb
- 1.25%
- Multivariable mortality model (mean CO-Hb (mCO-Hb), mean Met-Hb (mMet-Hb)) AUC
- 0.803
Observational data: associations, not effects.
Original publication
Carboxyhemoglobin and Methemoglobin as Biomarkers of Hemolysis and Mortality in Acute Respiratory Distress Syndrome Treated by Veno-Venous Extracorporeal Membrane Oxygenation. Anesth Analg. Published 31 March 2025. doi:10.
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