Methemoglobin as a marker of acute anemic stress in cardiac surgery

Autores de IIS La Fe

• Paula Carmona García

  Autor

Participantes ajenos a IIS La Fe

• Mistry, Nikhil
• Hare, Gregory M. T.
• Shehata, Nadine
• Kramer, Robert S.
• Fawzy, Hosam F.
• Baker, Robert A.
• Saczkowski, Richard
• Filipescu, Daniela
• Alphonsus, Christella S.
• Rochon, Antoine
• Gregory, Alexander J.
• Khanykin, Boris
• Leff, Jonathan D.
• Mateo, Eva
• Karangelis, Dimos
• Tellez, Juan C.
• Saha, Tarit
• Ko, Dennis T.
• Verma, Duminda N. Subodh
• Verma, Subodh
• Mazer, C. David

Grupos

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Medicina Perioperatoria, Anestesiología y Reanimación

  

  Leader

  Óscar Díaz Cambronero

Abstract

Biological evidence supports plasma methemoglobin as a biomarker for anemia induced tissue hypoxia. In this translational planned substudy of the multinational randomized controlled transfusion thresholds in cardiac surgery (TRICS-III) trial, which included adults undergoing cardiac surgery requiring cardiopulmonary bypass with a moderate-to-high risk of death, we investigated the relationship between perioperative hemoglobin concentration (Hb) and methemoglobin; and evaluated its association with postoperative outcomes. The primary endpoint was a composite of death, myocardial infarction, stroke, and severe acute kidney injury at 28 days. We observe weak non-linear associations between decreasing Hb and increasing methemoglobin, which were strongest in magnitude at the post-surgical time point. Increased levels of post-surgical methemoglobin were associated with a trend toward an elevated risk for stroke and exploratory neurological outcomes. Our generalizable study demonstrates post-surgical methemoglobin may be a marker of anemia-induced organ injury/dysfunction, and may have utility for guiding personalized approaches to anemia management.

© 2023.

Keywords

• Cardiovascular medicine; Health sciences; Public health; Surgery