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

Area of Science:

• Cardiovascular Research
• Hematology
• Biomedical Engineering

Background:

• Extracorporeal membrane oxygenation (ECMO) is linked to bleeding and clotting issues.
• ECMO circuits can trigger inflammation, hemolysis, and acquired von Willebrand syndrome, affecting blood cells.

Purpose of the Study:

• To prospectively analyze red blood cell (RBC) aggregation and elongation (deformability) and platelet aggregation during the first week of ECMO.
• To investigate the impact of ECMO on blood rheology and cellular function.

Main Methods:

• Prospective observational study of 16 patients undergoing ECMO.
• Blood samples collected pre-ECMO and on days 1, 2, 3, 5, and 7.
• RBC aggregation/elongation assessed by laser-assisted optical rotational red cell analyzer (Lorrca).
• Platelet function analyzed using multiple electrode aggregometry (Multiplate®).

Main Results:

• Significant time-dependent changes observed in RBC aggregation indices (upstroke, top, amplitude).
• RBC elongation index increased at high shear stress on day 2 (p=0.004) then decreased.
• No significant differences in platelet aggregation (ADP, TRAP, Ristocetin) were found during ECMO compared to baseline.

Conclusions:

• ECMO appears to affect RBC rheology, particularly deformability at high shear stress, more profoundly than platelet aggregation.
• Altered RBC function may contribute to ECMO-related complications.