Hemolysis in Cardiopulmonary Bypass: Mechanisms, Biomarkers, Technological Factors, and Current Research Gaps.

This review looks at hemolysis during cardiopulmonary bypass (CPB). It covers shear stress, blood-air interfaces,suction-induced trauma, and circuit factors like pump design and oxygenator setup. Key biomarkers for trackinghemolysis, such as plasma free hemoglobin, lactate dehydrogenase, and haptoglobin, are also included. It alsoassesses how pump type, circuit coatings, priming solutions, and venous drainage strategies influence bloodtrauma.Current research reveals several limitations. These include inconsistent methods, differing biomarker samplingtimes, and conflicting data on CPB hardware effectiveness. The absence of standardized clinical guidelines forpreventing hemolysis adds to the variability. More emphasis on population-specific studies and integrated circuitanalysis is essential for understanding and reducing hemolysis in CPB.Addressing these gaps is vital for creating standardized perfusion protocols and enhancing safety during cardiacsurgery.