The expanded use of extracorporeal membrane oxygenation (ECMO) is driven by the reported benefits of ECMO, both in terms of physiology by its mitigation of hypercarbia, acidosis, and concomitant pulmonary vascular resistance. However, the potential contribution of ECMO to the systemic inflammatory response continues to halt clinical decisions to utilize the strategy. The objective of our study is to evaluate the role of inflammatory cytokines and chemokines in ECMO patients pre-ECMO and up to 48H post-ECMO. METHODS: Blood samples from consenting adults who received ECMO treatment (either veno-venous or veno-arterial) were collected immediately pre-ECMO and Day 1 or 2 post-ECMO cannulation. Samples were analyzed by BioPlex assay, where antibodies and red and infrared fluorophores were attached to each surface of a bead, which was combined with the plasma sample. Biotinylated detection antibodies were added to quantify the analytes, and lasers read the color code of each bead and measured the fluorescence of the biotin bound streptavidin conjugates. RESULTS: 38 of the 46 analytes measured decreased post-ECMO initiation. The following analytes were significantly decreased between pre- and post-ECMO initiation: IL-16 ( p =0.027), RANTES ( p =0.022), IL-8 ( p =0.022), IFN-γ ( p =0.025), and IL-9 ( p =0.022). CONCLUSIONS: We have shown that baseline values of the majority of the inflammatory cytokines and chemokines are not exacerbated by placement on ECMO. Instead, we provide preliminary evidence that placement on ECMO may attenuate the inflammatory and immune response to cardiopulmonary injury. Further studies will increase the number of subject data analyzed and their timepoints, and it will correlate the biomarkers to outcomes.
DellaVolpe et al. (Tue,) studied this question.