Prevention and Management of Hemolysis when Utilizing Mechanical Circulatory Support.

Hemolysis is a significant complication of mechanical circulatory support. It appears more frequent during microaxial flow pump (mAFP) than extracorporeal membrane oxygenation (ECMO) treatment. During mAFP treatment, the main causes of hemolysis are malpositioning, left ventricular underfilling, and thrombosis. During ECMO treatment, lack of preload is a common cause of suction, but circuit kinking/thrombosis as well as pump or oxygenator thrombosis are important causes of hemolysis. A systematic diagnostic approach is proposed throughout this article, since the mainstay of treatment is correction of the underlying cause; although temporizing measures are also described in further detail.