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

Stephaine Houston1, Shruti Patel2, Aditya Badheka2

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

Perfusion
|June 1, 2021
PubMed

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:
ECMOacute kidney injuryhemolysispediatricsplasma free hemoglobintotal plasma exchange

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