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Extracorporeal membrane oxygenation without anticoagulation: a study using quantitative scanning electron microscopy.

S K Kundu1, S O Salley, G C Whittlesey

  • 1Department of Chemical Engineering, Wayne State University, Detroit, MI.

The Journal of Laboratory and Clinical Medicine
|July 1, 1989
PubMed
Summary
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Systemic heparinization during extracorporeal membrane oxygenation (ECMO) in rabbits showed no benefit and increased platelet activation. These findings suggest current heparin dosages may be unwarranted for short-term ECMO procedures.

Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Hematology

Background:

  • Heparin is standard for preventing thrombosis in extracorporeal circulation (ECC).
  • Systemic heparinization increases bleeding risks and impairs coagulation.
  • ECC can potentially be performed without anticoagulants or surface treatments.

Purpose of the Study:

  • To evaluate the necessity of systemic heparinization in short-term extracorporeal membrane oxygenation (ECMO).
  • To compare thrombosis in ECMO circuits with and without heparin or surface coating.

Main Methods:

  • Short-term ECMO was performed on rabbits in three groups: systemic heparin, no anticoagulation, and albumin-heparin complex surface-coated circuits.
  • Quantitative scanning electron microscopy assessed thrombosis by measuring blood component adhesion.

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Main Results:

  • No significant differences in blood component adhesion were found between groups.
  • Increased platelet activation and attachment were observed in the systemic heparin group.
  • Systemic heparinization demonstrated no benefit in short-term ECMO.

Conclusions:

  • Current systemic heparinization levels for short-term ECMO may be excessive.
  • Further controlled studies are needed to determine optimal anticoagulation for various ECC applications.