Platelet-derived microparticles generated by neonatal extracorporeal membrane oxygenation systems

摘要: Current anticoagulation strategies do not eliminate thromboembolic stroke or limb loss during neonatal extracorporeal membrane oxygenation (ECMO), a form of cardiopulmonary bypass (CPB). In adults, CPB surgery generates prothrombotic platelet-derived microparticles (PMPs), submicron vesicles released from activated platelets. However, information on PMP generation in ECMO systems is lacking. The objective this study was to compare five different systems, using simulated circuit with swine blood at 300 ml/min for 4 hours. Systems were composed both newer components (centrifugal pump and hollow-fiber oxygenator) traditional (roller-head silicone oxygenator). Free plasma hemoglobin levels measured as an indicator hemolysis flow cytometry-measured PMP. Hemolysis generated all similar that observed noncirculated static (p = 0.48). There no difference net between oxygenators given pump. contrast, centrifugal least 2.5 times greater than roller-head systems. This significant when either < 0.005) 0.05) oxygenator. Future studies are needed define the relationship pump-generated thrombosis.