Open AccessHigh Hemoglobin Level As a Limiting Factor for Extracorporeal Membrane Oxygenation
Author(s) -
Lionel Ursulet,
Charalampos Pierrakos,
Antonella Cudia,
Dimitrios Velissaris,
Eddy Janssenswillen,
Jacques Devriendt,
David De Bels
Publication year - 2019
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000000959
Subject(s) - extracorporeal membrane oxygenation , medicine , oxygenation , hyperviscosity , acute respiratory distress , anesthesia , extracorporeal , intensive care medicine , cardiology , surgery , lung , blood viscosity
We report the case of a 47 year old male who developed acute respiratory distress syndrome after bariatric surgery, requiring a venovenous extracorporeal membrane oxygenation. An inadequate extracorporeal membrane oxygenation output flow was observed, possibly because of severe polycythemia and hyperviscosity. Management with acute normovolemic hemodilution corrected both the biologic and hemodynamic parameters. To our knowledge, this is the first reported case of acute normovolemic hemodilution to improve extracorporeal membrane oxygenation outflow. Clinicians should be aware that polycythemia and hyperviscosity may impair extracorporeal membrane oxygenation support and that acute normovolemic hemodilution may be a safe and efficient procedure to address such matter. The optimal hemoglobin level on extracorporeal membrane oxygenation deserves further investigation.