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Prognostic indicators in VA-ECMO: Insights from thromboinflammatory markers
Shengqiang Pei1, Jie Xu1, Zixin Chen1
1Center of Laboratory Medicine, State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, 100037, PR China.
Thrombosis Research
|July 23, 2026
Summary
Neutrophil extracellular traps (NETs) and S100A8/A9 are elevated in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients, predicting adverse outcomes. Targeting NETs may improve prognosis in VA-ECMO patients.
Area of Science:
- Cardiovascular Research
- Critical Care Medicine
- Immunology
Background:
- Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is vital for cardiogenic shock but complicated by thromboinflammation.
- Neutrophil extracellular traps (NETs) and S100A8/A9 are implicated in this process, but their prognostic value in VA-ECMO is unclear.
Purpose of the Study:
- To analyze dynamic changes in NETs and S100A8/A9 during VA-ECMO.
- To assess the predictive value of these markers for adverse outcomes in VA-ECMO patients.
Main Methods:
- Prospective cohort study of 24 VA-ECMO patients.
- Measurement of plasma CitH3, dsDNA, and S100A8/A9 at baseline, 48h, and pre-decannulation.
- In vivo validation using DNaseI in rat VA-ECMO models.
Main Results:
- S100A8/A9 and CitH3 levels remained elevated, higher in patients with ECMO withdrawal.
- These markers positively correlated with ECMO withdrawal and outperformed C-reactive protein in prediction.
- CitH3 was identified as a superior prognostic indicator; DNaseI reduced S100A8/A9 and prolonged ECMO support in rats.
Conclusions:
- NETs-related markers show strong association with adverse VA-ECMO outcomes.
- These markers offer superior prognostic value over traditional biomarkers.
- Targeting NETs presents a potential therapeutic strategy for VA-ECMO patients.
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