Incidence rate, risk factors and outcome of hyperbilirubinemia in adult cardiac patients supported by extracorporeal membrane oxygenation
- VernacularTitle:成人体外膜肺氧合支持过程中高胆红素血症的发生率、危险因素及结局
- Author:
Lin LYU
1
;
Jingxin YAO
;
Guodong GAO
;
Cun LONG
;
Feilong HEI
;
Bingyang JI
;
Jinping LIU
;
Kun YU
;
Jinxiao HU
;
Qiang HU
Author Information
- Keywords: extracorporeal membrane oxygenation; hyperbilirubinemia; risk factors
- From: Journal of Clinical Medicine in Practice 2017;21(13):56-60
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the incidence rate,risk factors and outcome of hyperbilirubinemia in adult cardiac patients supported by extracorporeal membrane oxygenation(ECMO).Methods Clinical data of 89 adult cardiac patients with ECMO in Fuwai Hospital were retrospectively analyzed.All patients were divided into normal group,high bilirubin group and severe high bilirubin group.In a multiple linear regression analysis,logarithmic transformation was performed for non-normally distributed variables.Results The incidence rate of hyperbilirubinemia was 73％,including 30 cases in high bilirubin group and 35 cases in severe high bilirubin group.A multiple linear regression analysis showed that lg(peak TBIL+1)was significantly associated with lg(peak AST+1)(P=0.001),lg(peak free hemoglobin +1)(P=0.003)and TBIL before ECMO(P=0.009).There was also a linear correlation between peak TBIL and TBIL before ECMO support(P=0.011),peak AST(P=0.004)and peak free hemoglobin during ECMO(P<0.001).The patients in severe high bilirubin group had lower platelets during ECMO,and the survival rate was the lowest.Conclusion Hyperbilirubinemia remains common in patients with ECMO,and is associated with low platelet and a high rate of in-hospital mortality.Hemolysis and liver dysfunction during ECMO support and high bilirubin level before ECMO are risk factors of hyperbilirubinemia.
