Platelet activation and degradation in an experimental extracorporeal system. A comparison between a silicone membrane and a hollow-fibre oxygenator

Mellgren, Karin; Skogby, Maria; Järnås, Å.; Friberg, Lena E.; Wadenvik, Hans; Mellgren, Gösta

doi:10.1177/026765919601100505

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…This decline in platelet count can be explained by adherence of platelets to the artificial surfaces of the extracorporeal circuit. In previous studies reported by us and by other groups, reduced platelet consumption during in vitro extracorporeal circulation with NO was observed (1). Also, during cardiopulmonary bypass in pigs, where NO was added to the oxygenator sweep gas, a similar effect has been reported (2).…”

Section: Discussionsupporting

confidence: 66%

“…In a previous study, our group observed that nitric oxide (NO), added to the oxygenator sweep gas in an in vitro extracorporeal circulation system, prevented platelet activation and consumption (1). NO has also been added to the oxygenator sweep gas in pigs undergoing cardiopulmonary bypass, in order to reduce platelet consumption (2).…”

Section: Extracorporeal Membrane Oxygenation (Ecmo)mentioning

confidence: 99%

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The Effect of S‐Nitroso‐Glutathione on Platelet and Leukocyte Function During Experimental Extracorporeal Circulation

et al. 2003

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Treatment with extracorporeal membrane oxygenation ECMO) is associated with side effects, e.g., blood cell consumption and activation. Our group has earlier shown that nitric oxide administered as a gas reduces platelet consumption and activation. In the present work we have studied the effect of the NO-donor S-nitroso-glutathione GSNO) on platelets and leukocytes in an in vitro extracorporeal circuit. Two complete ECMO circuits were perfused with fresh heparinized human blood for 24 hours. GSNO was administered as a continuous infusion to one circuit at a rate of 0.7 mg/hour in four paired experiments and at a rate of 3.5 mg/hour in another four paired experiments. The other circuit was used as a control. Blood samples were withdrawn from both circuits before the start of the experiments and at 0.5, 1, 3, 12, and 24 hours of perfusion. The samples were analyzed for red blood cell count, leukocyte count, platelet count, platelet membrane expression of glycoproteins GP) Ib and GPIIb/IIIa, leukocyte membrane expression of cluster of differentiation CD) 11b/CD18, as well as plasma concentration of tumor necrosis factor TNF)-alpha, interleukin IL)-1beta, and IL-8. No difference in these parameters between the GSNO and the control circuit at any time point was assayed. In this study, no significant effect of GSNO on circulating platelets or leukocytes during experimental extracorporeal circulation could be shown.

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Section: Discussionsupporting

confidence: 66%

Section: Extracorporeal Membrane Oxygenation (Ecmo)mentioning

confidence: 99%

The Effect of S‐Nitroso‐Glutathione on Platelet and Leukocyte Function During Experimental Extracorporeal Circulation

et al. 2003

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“…To the best of our knowledge, despite the abundance of studies that quantitatively assessed the effect of platelet activation (i.e., thrombus formation) in ECC components (Mellgren et al 1996;Tanaka et al 2001), there are no studies that quantitatively assessed the mechanical factors initiating platelet activation in ECC membrane oxygenators. Gartner et al (2000) demonstrated that low velocity regions qualitatively matched regions with a high incidence of thrombotic deposition.…”

Section: Discussionmentioning

confidence: 99%

Computational evaluation of the thrombogenic potential of a hollow-fiber oxygenator with integrated heat exchanger during extracorporeal circulation

Pelosi

Sheriff

Stevanella

et al. 2012

Biomech Model Mechanobiol

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The onset of thromboembolic phenomena in blood oxygenators, even in the presence of adequate anticoagulant strategies, is a relevant concern during extracorporeal circulation (ECC). For this reason, the evaluation of the thrombogenic potential associated with extracorporeal membrane oxygenators should play a critical role into the preclinical design process of these devices. This study extends the use of computational fluid dynamics simulations to guide the hemodynamic design optimization of oxygenators and evaluate their thrombogenic potential during ECC. The computational analysis accounted for both macro- (i.e., vortex formation) and micro-scale (i.e., flow-induced platelet activation) phenomena affecting the performances of a hollow-fiber membrane oxygenator with integrated heat exchanger. A multiscale Lagrangian approach was adopted to infer the trajectory and loading history experienced by platelet-like particles in the entire device and in a repetitive subunit of the fiber bundles. The loading history was incorporated into a damage accumulation model in order to estimate the platelet activation state (PAS) associated with repeated passes of the blood within the device. Our results highlighted the presence of blood stagnation areas in the inlet section that significantly increased the platelet activation levels in particles remaining trapped in this region. The order of magnitude of PAS in the device was the same as the one calculated for the components of the ECC tubing system, chosen as a term of comparison for their extensive diffusion. Interpolating the mean PAS values with respect to the number of passes, we obtained a straightforward prediction of the thrombogenic potential as a function of the duration of ECC.

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“…It is known that hemolysis occurs while on CPB. In a comparative study of biocompatibility between a membrane and hollow fiber oxygenator, Mellgren et al (12) evaluated free hemoglobin levels in plasma at 60 ± 10 mg/dl and 310 ± 80 mg/dl in both groups after a 24 hr investigation period. The values measured in our study were 43 ± 30 mg/dl in the DBT group and 28 ± 6.6 mg/dl in the control group after a 3 hr recirculation period.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Biocompatibility Evaluation of the Dynamic Bubble Trap

et al. 2003

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The goal of this study was to evaluate the biocompatibility of the dynamic bubble trap (DBT) prior to the clinical trial. It was set up as an in vitro model, which simulates physiological conditions. Twenty runs were performed (ten with the DBT, ten without the DBT) at a blood flow of 3 l/min, each lasting 180 min. Fifteen blood parameters (hemogram, hemostasis, complement system, and cytokines) were measured at five time intervals. None of the tested parameters showed a statistically significant difference between the DBT and control group. The data assessed in this in vitro model show that the DBT has no adverse influence on hemocompatibility. It may be concluded that the DBT is a safe tool to be used in vivo.

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Platelet activation and degradation in an experimental extracorporeal system. A comparison between a silicone membrane and a hollow-fibre oxygenator

Cited by 8 publications

References 11 publications

The Effect of S‐Nitroso‐Glutathione on Platelet and Leukocyte Function During Experimental Extracorporeal Circulation

The Effect of S‐Nitroso‐Glutathione on Platelet and Leukocyte Function During Experimental Extracorporeal Circulation

Computational evaluation of the thrombogenic potential of a hollow-fiber oxygenator with integrated heat exchanger during extracorporeal circulation

In Vitro Biocompatibility Evaluation of the Dynamic Bubble Trap

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