Key result
PLS oxygenators exhibited heterogeneous cellular deposits, including clusters (44%) and pseudomembranes (22%), compared to only small deposits in Hilite oxygenators, without signs of clot formation.
Why the study?
Despite antithrombogenic coatings improving ECMO circuit hemocompatibility, thrombus formation remains a risk within the membrane oxygenator, prompting evaluation of cellular accumulations on gas exchange capillaries across different ECMO systems.
Does the type of membrane oxygenator affect the extent of cellular deposits and indicators of clot formation in adult ECMO patients?
Observational (n=34)
Does the type of membrane oxygenator affect the extent of cellular deposits and indicators of clot formation in adult ECMO patients?
Despite histological differences in cellular deposits between PLS and Hilite membrane oxygenators, there is no evidence that these deposits indicate increased clot formation.
Deposits on Hilite oxygenators show no coagulation correlation; leaves open differential biocompatibility across ECMO systems.
Antithrombogenic coatings of artificial surfaces within extracorporeal membrane oxygenation (ECMO) circuits improved its bio- and hemocompatibility. However, there is still a risk of thrombus formation in particular within the membrane oxygenator (MO). Since inflammatory cells are essential components within clots, the aim was to identify the extent of cellular accumulations on gas exchange capillaries from different ECMO systems. Thirty-four MOs (PLS, n = 27, Getinge; Hilite 7000 LT, n = 7, Fresenius Medical Care, Germany) were collected from adult patients. The extent of cellular deposits on gas exchange capillaries was classified using nuclear 4',6-diamidino-2-phenylindole staining and fluorescence microscopy. All Hilite oxygenators exhibited small cellular deposits. In contrast, the cellular distribution was heterogeneous on capillaries from PLS oxygenators: small deposits (34%), clusters (44%) and membrane-spanning cell structures (pseudomembranes) (22%). Overall, the median fluorescence intensity was significantly higher in the PLS group. Nevertheless, within 3 days before MO removal, there was no alteration in critical parameters ( d -dimer and fibrinogen levels, platelet counts, and pressure drop across the MO). In conclusion, despite the histological differences on the gas capillaries from different types of oxygenators, there was no further evidence of increased inflammation and coagulation parameters that indicate clot formation within oxygenators.
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Dropco et al. (2023) conducted an observational in Extracorporeal membrane oxygenation (n=34). PLS oxygenators vs. Hilite 7000 LT oxygenators was evaluated on Extent of cellular deposits on gas exchange capillaries. PLS oxygenators exhibited heterogeneous cellular deposits, including clusters (44%) and pseudomembranes (22%), compared to only small deposits in Hilite oxygenators, without signs of clot formation.
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