Methemoglobin as a marker of acute anemic stress in cardiac surgery

iScience. 2023 Jul 20;26(8):107429. doi: 10.1016/j.isci.2023.107429. eCollection 2023 Aug 18.ABSTRACTBiological 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. Clinicaltrials.gov registration NCT02042898.PMID:37575193 | PMC:PMC10415918 | DOI:10.1016/j.isci.2023.107429

Source: Pain Physician - August 14, 2023 Category: Anesthesiology Authors: Nikhil Mistry Gregory M T Hare Nadine Shehata Robert S Kramer Hosam F Fawzy Robert A Baker Paula Carmona Richard Saczkowski Daniela Filipescu Christella S Alphonsus Antoine Rochon Alexander J Gregory Boris Khanykin Jonathan D Leff Eva Mateo Dimos Karangel Source Type: research