Hemolysis intraoperative monitoring by Helge V-test in patients undergoing extracorporeal circulation in cardiac surgery: a single center data

Abstract Purpose Hemolysis is a complication in all surgical procedures requiring extracorporeal circulation (ECC). The aim of this study is to evaluate the effectiveness of the disposable point of care device Hemcheck Helge™ V-TEST quantifying hemolysis during cardiac surgery in ECC. Methods Two whole blood samples of 78 patients were simultaneously collected at different times of surgery: T0 pre ECC; T1 at the time of clamping of aorta; T2 at 20 minutes after the start of ECC; T3 at the end of ECC; T4 at the end of surgery. Both samples were analyzed by the disposable Hemcheck Helge™ V-TEST device, which offers a real-time assessment of hemolysis through a value of plasma free hemoglobin (PfHb) expressed in mg/dL. Results Out of all cases analyzed, no case of hemolysis (PfHb ≥ 50 mg/dL) was recorded at T0. The results recorded median PfHb values at T0 0.5 (0-7.1) mg/dL, at T1 3.75 (0-14.4) mg/dL; at T2 8.25 (0.4–19.1) mg/dL, at T3 27.5 (9.9–50) mg/dL, at T4 18.5 (2.4–41) mg/dL; for all T time p value was < 0.001. A statistically significant correlation was recorded between hemolysis values > 50 mg / dL at T3 and ECC time > 100 minutes (p < 0,05). Conclusions The use of Hemcheck Helge™ V-TEST allows effective identification of hemolysis directly in the operating room, reducing wasted time for laboratory analyses. This could help the anesthetist, perfusionist or cardiac surgeon approaching earlier intraoperative hemolysis and its effects on organs function and improve the post-operative course of patients undergoing cardiac surgery in ECC.