Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous extracorporeal membrane oxygenation (ECMO)
Authors' conclusion
Moderate hemolysis with mCFH-levels as low as 11 mg/dl impacts mortality in patients with ARDS and therapy with veno-venous ECMO.
Study context
- Population
- Patients with ARDS treated with veno-venous ECMO at a tertiary ARDS referral center, 01/2007–12/2018
- Participants
- 442 patients
- Exposure
- Mean CFH (mCFH) >11 vs ≤11 mg/dl; Mean Hp (mHp) ≤0.39 vs >0.39 g/l
- mCFH ≤ 11 mg/dln = 277reference
- mCFH > 11 mg/dln = 165
- mHp ≤ 0.39 g/ln = 163
- mHp > 0.39 g/ln = 279reference
- Outcome
- ICU mortality by CFH and Hp cutoff values
Methodological detailssingle-centre, tertiary ARDS referral center, multiple logistic regression with stepwise backward variable selection
- Single-centre
- Tertiary ARDS referral center
- Multiple logistic regression with stepwise backward variable selection
Main finding
As reported in the abstract
ICU mortality
Odds ratio (CI)P value
CFH Grouping
3.77(2.51–5.72)
P < 0.001Hp Grouping
0.29(0.19–0.43)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| ICU mortality by share of therapy days with CFH > 11 mg/dl (cutoff 13.3%)> 13.3% of days with CFH > 11 mg/dl vs ≤ 13.3% of days with CFH > 11 mg/dl | ≤ 13.3% of days with CFH > 11 mg/dl 33% (CI 26.81–40.54) · n = 192 · > 13.3% of days with CFH > 11 mg/dl 62% (CI 56.05–68.36) · n = 250 | P < 0.001 |
| ICU mortality by share of therapy days with Hp ≤ 0.39 g/l (cutoff 18.2%)> 18.2% days with Hp ≤ 0.39 g/l vs ≤ 18.2% days with Hp ≤ 0.39 g/l | ≤ 18.2% days with Hp ≤ 0.39 g/l 27% (CI 19.80–35.14) · n = 138 · > 18.2% days with Hp ≤ 0.39 g/l 60% (CI 54.43–65.70) · n = 304 | P < 0.001 |
Original publication
Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous ECMO. J Intensive Care. Published 20 April 2023. doi:10.
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