Biomolecules (May 2021)

Impact of Venoarterial Extracorporeal Membrane Oxygenation on Alkaline Phosphatase Metabolism after Cardiac Surgery

  • Thomas Poschner,
  • Anne-Kristin Schaefer,
  • Doris Hutschala,
  • Georg Goliasch,
  • Julia Riebandt,
  • Klaus Distelmaier,
  • Martin H. Bernardi,
  • Martin Andreas,
  • Ruud Brands,
  • Tandis Aref,
  • Günther Laufer,
  • Dominik Wiedemann

DOI
https://doi.org/10.3390/biom11050748
Journal volume & issue
Vol. 11, no. 5
p. 748

Abstract

Read online

(1) Alkaline phosphatase (AP) is consumed during cardiopulmonary bypass (CPB). A high AP depletion leads to an impaired outcome after cardiac surgery. However, data is scarce on the postoperative course of AP under venoarterial ECMO (VA-ECMO) support. (2) A total of 239 patients with VA-ECMO support between 2000 and 2019 at the Department of Cardiac Surgery (Vienna General Hospital, Austria) were included in this retrospective analysis. Blood samples were collected at several timepoints (baseline, postoperative day (POD) 1–7, POD 14 and 30). Patients were categorized according to the relative AP drop (p = 0.000). A greater AP drop was associated with a significantly higher need for renal replacement therapy (40.9% vs. 61.9%; p = 0.002) and an impaired 1-year survival (51.4% vs. 66.0%; p = 0.031). (4) CPB exceeds the negative impact of VA-ECMO; still, ECMO seems to delay alkaline phosphatase recovery. A greater initial AP drop bears the risk of higher morbidity and mortality.

Keywords