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Updated: Apr 22, 2026
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Platelet-derived microparticles generated by neonatal extracorporeal membrane oxygenation systems
Andrew D Meyer1, Jonathan A L Gelfond, Andrew A Wiles
1From the *Division of Pediatric Critical Care, Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; †Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; ‡Department of Integrative Systems Biology, Children's National Medical Center, Washington, District of Columbia; and §Division of Neonatology, Center for Hospital-based Subspecialties, Children National Medical Center, Washington, District of Columbia.
Neonatal extracorporeal membrane oxygenation (ECMO) systems with centrifugal pumps generate significantly more prothrombotic platelet-derived microparticles (PMPs) than those with roller-head pumps. This finding is crucial for understanding thrombosis risk during neonatal ECMO.
Area of Science:
- Biomedical Engineering
- Pediatric Cardiology
- Hematology
Background:
- Neonatal extracorporeal membrane oxygenation (ECMO) is a life support technique for infants with severe cardiopulmonary failure.
- Current anticoagulation strategies are insufficient to prevent thromboembolic complications like stroke and limb loss during neonatal ECMO.
- Platelet-derived microparticles (PMPs), released from activated platelets, are known contributors to thrombosis in adult cardiopulmonary bypass (CPB) systems, but their generation in neonatal ECMO is understudied.
Purpose of the Study:
- To compare PMP generation across five distinct neonatal ECMO systems.
- To investigate the influence of different pump types (centrifugal vs. roller-head) and oxygenators (hollow-fiber vs. silicone membrane) on PMP production.
- To assess hemolysis as a secondary outcome in these simulated neonatal ECMO circuits.
Main Methods:
- A simulated neonatal ECMO circuit using swine blood was run at 300 ml/min for 4 hours.
- Five different ECMO system configurations were tested, combining centrifugal and roller-head pumps with hollow-fiber and silicone membrane oxygenators.
- Flow cytometry was used to quantify PMP levels, and free plasma hemoglobin was measured to assess hemolysis.
Main Results:
- Hemolysis levels across all tested ECMO systems were comparable to static blood, indicating minimal blood trauma from the circuits themselves.
- No significant difference in net PMP levels was observed between different oxygenator types when paired with the same pump.
- ECMO systems utilizing a centrifugal pump generated at least 2.5 times more PMPs than those with a roller-head pump, regardless of the oxygenator type (p < 0.005 for hollow-fiber, p < 0.05 for silicone membrane).
Conclusions:
- The type of pump significantly influences PMP generation in neonatal ECMO circuits, with centrifugal pumps being a major source.
- Understanding the relationship between pump-induced PMP generation and thrombotic events is critical for improving neonatal ECMO safety.
- Further research is warranted to elucidate the direct link between PMP levels and thrombosis risk in neonates undergoing ECMO.
