THE ROLE OF THE CENTRIFUGAL PUMP IN HEMOLYSIS DURING NEONATAL EXTRACORPOREAL SUPPORT

While the use of the centrifugal vortex ECMO pump as an alternative to a roller-occlusion pump offers distinct advantages, unacceptable hemo lysis may occur during its use in newborn infants. The authors studied 87 consecutive neonatal patients with respiratory failure supported w ith venoarterial ECMO using a centrifugal vortex pump. Baseline mean p lasma free hemoglobin level for all patients during the first 48 hours of bypass was 31.3 +/- 3.1 mg/dl. In 51 patients, an abrupt rise in t he plasma free hemoglobin occurred. In 48 of 51 patients, the pump hea d alone was changed at 91.9 +/- 6.6 hours after initiation of bypass. Mean plasma free hemoglobin decreased to baseline values following pum p head change. The authors could not determine any factors that distin guished the infants who developed hemolysis from those who did not. Ch anging only the pump head provides a simple approach to hemolysis enco untered during use of the centrifugal vortex pump in newborn infants.