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Hemolysis in extracorporeal circulation: relationship between time and procedures

Francisco Ubaldo Vieira Junior1, Nilson Antunes, Reinaldo Wilson Vieira

  • 1State University of Campinas, Instituto Federal de São Paulo, Brazil. fubaldo@terra.com.br

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|March 22, 2013
PubMed

Insights

The initial five minutes of extracorporeal circulation (EC) during coronary artery bypass grafting cause the highest rate of blood hemolysis. Hemolysis rates remained stable during aortic suction and residual volume passage.

Area of Science:

  • Cardiovascular Surgery
  • Hemodynamics
  • Blood Compatibility

Background:

  • Extracorporeal circulation (EC) is a critical component of modern cardiac surgery.
  • However, EC is associated with significant blood trauma, notably hemolysis.
  • Understanding hemolysis during EC is vital for patient safety and outcomes.

Purpose of the Study:

  • To quantify the rate of hemolysis at various time points during EC.
  • Specifically, to assess hemolysis during elective coronary artery bypass grafting (CABG).

Main Methods:

  • Hemolysis rates were measured in 22 patients undergoing myocardial revascularization with EC.
  • Measurements were taken at six distinct time points: pre-EC, 5 minutes post-initiation, 30 minutes, pre-aortic unclamping, pre-residual volume passage, and 5 minutes post-passage.
  • Hemolysis rates were calculated across defined intervals.

Main Results:

  • The highest rate of hemolysis was observed within the first five minutes of EC initiation (P = 0.0003).
  • This initial period accounted for 29% of the total hemolysis observed up to the point of residual volume passage.
  • No significant hemolysis changes were noted during aortic root suction or residual volume management.

Conclusions:

  • The early phase of extracorporeal circulation presents the highest risk for hemolysis.
  • Hemolysis rates are not significantly affected by aortic suction or the method of residual volume return.
  • These findings highlight the importance of monitoring and potentially mitigating hemolysis during the initial stages of EC.
Abstract

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