Carboxyhemoglobin levels for the detection of hemolysis in patients supported by left ventricular assist devices: A case series

Hemolysis represents a severe, potentially life-threatening complication of extracorporeal circulation and percutaneous transvalvular microaxial flow pumps. Endogenous carbon monoxide (CO) production, measured via point-of-care (POC) CO-metry, has been investigated as a potential early marker of hemolysis in patients supported by extracorporeal membrane oxygenation (ECMO). We report two cases of hemolysis during percutaneous transvalvular microaxial flow pump therapy associated with significantly elevated carboxyhemoglobin (CO-Hb) levels. Consequently, we hypothesize that CO-Hb serves as a readily available bedside parameter for the early detection of hemolysis in this patient population.