Changes in Red Blood Cell Properties and Platelet Function during Extracorporeal Membrane Oxygenation

Journal of Clinical Medicine

Adrianus de Vries¹  Roland Hoffmann²  AnnemiekeOude Lansink-Hartgring³  Walter van den Bergh³ 

[1] Department of Anesthesiology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;Department of Cardiothoracic Surgery, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;Department of Critical Care, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands;

关键词: extracorporeal membrane oxygenation;    bleeding;    platelet function;   

DOI  :  10.3390/jcm9041168

来源: DOAJ

【 摘 要 】

Extracorporeal membrane oxygenation (ECMO) is associated with frequent hemorrhagic and thromboembolic complications. The multiple effects of ECMO include inflammatory response on contact with the circuit; hemolysis acquired von Willebrand syndrome likely affects the function of red blood cells (RBC) and platelets. The aim of this prospective observational study was to analyze RBC aggregation and elongation (deformability) and platelet aggregation in the first week of ECMO. Sixteen patients were included. Blood samples were taken prior to initiation of ECMO and on days 1, 2, 3, 5, and 7. RBC aggregation and elongation were analyzed using the laser-assisted optical rotational red cell analyzer (Lorrca). Upstroke, top, and amplitude as indices of aggregation showed significant time effects. RBC elongation was not affected at low shear stress. At high shear stress there was an increase in the elongation index at day 2 (p = 0.004), followed by a decrease. Platelet function was analyzed using multiple electrode aggregometry (Multiplate^®). In pairwise comparison in the days 1–7 to the value prior to ECMO there was no significant difference in platelet aggregation by any of the three agonists (ADP p = 0.61; TRAP p = 0.77; Ristocetin p = 0.25). This implies that the rheology of RBCs seemed to be more affected by ECMO than platelets. Especially the red blood cell deformability continues to decline at higher shear stress.

【 授权许可】

Unknown