185: Assessment of Plasma Free Hemoglobin in Swine During 72-hour Veno-Venous Extracorporeal CO2 Removal: HemoCue® versus HemCheck™

Introduction: Post injury pfHb is associated with outcomes in trauma patients. The HemCheck (HemCheck Sweden AB, [Karlstad, Sweden]) is a CE-marked simplified point-of-care hemolysis testing device. Using Bland-Altman analysis, we evaluated the HemCheck versus the FDA-approved HemoCue® Plasma/Low Hb System (HemoCue, [Angelholm, Sweden]) reference device for measurement of pfHb in swine with ARDS due to smoke inhalation injury and 40% total body surface area burns managed with or without extracorporeal CO2 removal. Methods: EDTA plasma from anesthetized, mechanically ventilated, Female Yorkshire swine (n=20) subjected to injury (smoke inhalation and burn), with or without ECLS (750-1000 ml/min blood flow) for 72-h was analyzed. Samples for assessment of pfHb were collected at baseline, post-injury, post-ECLS, then 6, 24, 48 and at 72-hours. The HemoCue® was used per manufacturer guidelines. For HemCheck, 0.1 ml of plasma was added to a HemCheck s-Test. Bland-Altman was performed to compare HemCheck against HemoCue. Results: See Figure. HemoCue values were systematically higher than HemCheck. No agreement was found between the two devices for the measure of pfHb when considering all data points overall due to skewness of data in the above 300mg/dL range of values. pfHb values in the 0-300mg/dL range showed good agreement HemCheck and HemoCue. Conclusions: In this cohort of animals with smoke inhalation injury and burns managed with and without VV ECCO2R, HemCheck showed good agreement with HemoCue values in the pfHb range of 0-300mg/dL. More research is needed for accurate assessment of pfHb in subjects with different injury patterns.