ArticleFrontiers in physiology2014
Hemolysis during cardiac surgery is associated with increased intravascular nitric oxide consumption and perioperative kidney and intestinal tissue damage.
Article in Frontiers in physiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02940327 (A Feasibility Study to Consider the Relationship Between Markers of Red Cell Damage, Inflammation and the Recovery Process of Newborns Requiring Extracorporeal Membrane Oxygenation), which is not on this map. Cited by 67 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Feasibility Study to Consider the Relationship Between Markers of Red Cell Damage, Inflammation and the Recovery Process of Newborns Requiring Extracorporeal Membrane Oxygenation (ECMO) for Persistent Pulmonary Hypertension of the Newborn (PPHN): Mi-ECMO
Who cites it
67 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Kidney protection during surgery on the thoracoabdominal aorta: a systematic review.Interdisciplinary cardiovascular and thoracic surgery · 2025Pooled it
- The beneficial use of nitric oxide during cardiopulmonary bypass on postoperative outcomes in children and adult patients: a systematic review and meta-analysis of 2897 patients.European journal of clinical pharmacology · 2023Pooled it
- Effects of crystalloid and colloid priming strategies for cardiopulmonary bypass on colloid oncotic pressure and haemostasis: a meta-analysis.Interactive cardiovascular and thoracic surgery · 2022Pooled it
- Dextran vs. Crystalloid Priming Solution in Cardiac Surgery: A Randomized Trial on Acute Kidney Injury.Acta anaesthesiologica Scandinavica · 2026Trial
- Corrigendum to: Kidney protection during surgery on the thoracoabdominal aorta: a systematic review.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Iron Compartmentalisation and Vascular Endothelial Cell Dysfunction.Antioxidants (Basel, Switzerland) · 2026Review
- Plasma from Cardiac Surgery Patients Induces Endothelial and Tubular Epithelial Cell Damage: Potential Role in Acute Kidney Injury Development-A Preliminary Report.International journal of molecular sciences · 2026Article
- Cardiopulmonary Bypass Flow Rate and the Kidney: Comment.Anesthesiology · 2026Article
- Hemolysis Detected Following the Preparation and Collection of Blood in a Porcine Model Using a Syringe-Based Aspiration Thrombectomy System for Autotransfusion.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Risk factors, outcomes, and early prediction of cardiac surgery-associated acute kidney injury: a post hoc subgroup analysis of the Epidemiology of Surgery Associated Acute Kidney Injury study.British journal of anaesthesia · 2026Article
- Cell-free hemoglobin is associated with microcirculatory perfusion disturbances and acute kidney injury in rats on extracorporeal membrane oxygenation.BMC anesthesiology · 2025Article
- Hemolysis and Its Clinical Implications in Septic Patients with Acute Respiratory Failure.Journal of clinical medicine · 2025Article
- Case Report: Successful management of acute kidney injury following interventional heartworm extraction in a dog with caval syndrome.Frontiers in veterinary science · 2025Article
- Gastrointestinal injury in cardiopulmonary bypass: current insights and future directions.Frontiers in pharmacology · 2025Review
- Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention.Renal failure · 2024Review
- Renal Outcome in Patients Undergoing Minimally Invasive Total Coronary Revascularization via Anterior Minithoracotomy Compared to Full Median Sternotomy Coronary Artery Bypass Grafting.Journal of clinical medicine · 2024Article
- The Association of Oxygen Delivery and Transfusion on Cardiopulmonary Bypass with Acute Kidney Injury.Journal of cardiothoracic and vascular anesthesia · 2024Article
- Subsequent kidney transplant after pediatric heart transplant: Prevalence and risk factors.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- The Nephroprotective Effect of Nitric Oxide during Extracorporeal Circulation: An Experimental Study.Biomedicines · 2024Article
- Neuron-specific enolase levels immediately following cardiovascular surgery is modulated by hemolysis due to cardiopulmonary bypass, making it unsuitable as a brain damage biomarker.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2024Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute kidney injury (AKI) and intestinal injury negatively impact patient outcome after cardiac surgery. Enhanced nitric oxide (NO) consumption due to intraoperative intravascular hemolysis, may play an important role in this setting. This study investigated the impact of hemolysis on plasma NO consumption, AKI, and intestinal tissue damage, after cardiac surgery.
methodsHemolysis (by plasma extracellular (free) hemoglobin; fHb), plasma NO-consumption, plasma fHb-binding capacity by haptoglobin (Hp), renal tubular injury (using urinary N-Acetyl-β-D-glucosaminidase; NAG), intestinal mucosal injury (through plasma intestinal fatty acid binding protein; IFABP), and AKI were studied in patients undergoing off-pump cardiac surgery (OPCAB, N = 7), on-pump coronary artery bypass grafting (CABG, N = 30), or combined CABG and valve surgery (CABG+Valve, N = 30).
resultsFHb plasma levels and NO-consumption significantly increased, while plasma Hp concentrations significantly decreased in CABG and CABG+Valve patients (p < 0.0001) during surgery. The extent of hemolysis and NO-consumption correlated significantly (r (2) = 0.75, p < 0.0001). Also, NAG and IFABP increased in both groups (p < 0.0001, and p < 0.001, respectively), and both were significantly associated with hemolysis (R s = 0.70, p < 0.0001, and R s = 0.26, p = 0.04, respectively) and NO-consumption (Rs = 0.55, p = 0.002, and R s = 0.41, p = 0.03, respectively), also after multivariable logistic regression analysis. OPCAB patients did not show increased fHb, NO-consumption, NAG, or IFABP levels. Patients suffering from AKI (N = 9, 13.4%) displayed significantly higher fHb and NAG levels already during surgery compared to non-AKI patients.
conclusionsHemolysis appears to be an important contributor to postoperative kidney injury and intestinal mucosal damage, potentially by limiting NO-bioavailability. This observation offers a novel diagnostic and therapeutic target to improve patient outcome after cardiothoracic surgery.
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