Key result
Veno-venous ECMO significantly reduced platelet aggregation at 6 hours compared to baseline, with spontaneous recovery to baseline by day two.
Why the study?
Veno-venous ECMO has negative effects on platelet count and function, but more information was needed on its impact on platelet function assessed by multiple electrode aggregometry.
Does vvECMO affect platelet function and count in ARDS patients?
Cohort (n=20)
Does vvECMO affect platelet function and count in ARDS patients?
vvECMO transiently reduces platelet aggregation which recovers by day two, though platelet count continues to decline, suggesting MEA may not fully capture late-stage platelet dysfunction.
Early platelet monitoring may be prudent with vvECMO initiation in ARDS; leaves open whether MEA detects ongoing dysfunction amid declining counts.
Extracorporeal (veno-venous) membrane oxygenation (vvECMO) has been shown to have negative effects on platelet number and function. This study aimed to gain more information about the impact of vvECMO on platelet function assessed by multiple electrode aggregometry (MEA). Twenty patients with the indication for vvECMO were included. Platelet function was analyzed using MEA (Multiplate®) before (T-1), 6 h (T0), one (T1), two (T2), three (T3), and seven (T4) days after the beginning of vvECMO. Median aggregational measurements were already below the normal reference range before vvECMO initiation. Platelet aggregation was significantly reduced 6 h after vvECMO initiation compared to T-1 and spontaneously recovered with a significant increase at T2. Platelet count dropped significantly between T-1 and T0 and continuously decreased between T0 and T4. At T4, ADP-induced platelet aggregation showed an inverse correlation with the paO2 in the oxygenator. Platelet function should be assessed by MEA before the initiation of extracorporeal circulation. Although ECMO therapy led to a further decrease in platelet aggregation after 6 h, all measurements had recovered to baseline on day two. This implies that MEA as a whole blood method might not adequately reflect the changes in platelet function in the later stages of extracorporeal circulation.
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Wand et al. (2019) conducted a cohort in ARDS requiring vvECMO (n=20). Veno-venous ECMO (vvECMO) vs. Baseline (before vvECMO) was evaluated on Platelet function assessed by multiple electrode aggregometry (MEA). Veno-venous ECMO significantly reduced platelet aggregation at 6 hours compared to baseline, with spontaneous recovery to baseline by day two.
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