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Septic porcine blood does not further activate coagulation during in vitro membrane oxygenation
- Source :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 51(3)
- Publication Year :
- 2016
-
Abstract
- Objectives For patients with a severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) represents a life-saving measure. Frequently, patients with severe ARDS also show signs of severe sepsis. As blood contact with the membrane oxygenator surface leads to adverse effects due to insufficient biocompatibility partly caused by activation of platelets, coagulation factors and leucocytes, we hypothesized that these adverse effects would be amplified if septic blood in a preactivated state came into contact with the membrane oxygenator. Methods In a previously established in vitro 12-h ECMO test system (mock loop), we used septic or healthy domestic pig blood to analyse coagulation and inflammatory parameters. Sepsis was induced by a caecal ligation and puncture model in pigs. Results At the beginning of the mock loop experiments, the septic blood showed significantly increased thrombin-antithrombin complexes (76.9 vs 27.7 µg/l), D-dimers (1.2 vs 0.3 mg/l) and fibrinogen concentration (1.8 vs 1.5 g/l), as well as elevated extrinsic coagulation activity (shorter EXTEM-CT: 44.2 vs 57 s) and higher lactate (3.4 vs 1.5 mmol/l) and cytokine levels (interleukin-6: 827 vs 31 pg/ml) when compared with the blood from healthy animals. Despite the preactivated status of the septic blood, no further increase of coagulation activity, inflammatory response or increased oxygenator resistance was observed in comparison to the control experiments. Conclusion Septic porcine blood was not further activated due to the contact with an oxygenator, and no increased clot formation or biocompatibility problems were observed.
- Subjects :
- Pulmonary and Respiratory Medicine
ARDS
Membrane oxygenator
medicine.medical_treatment
Sus scrofa
Biocompatible Materials
030204 cardiovascular system & hematology
Fibrinogen
Sepsis
03 medical and health sciences
0302 clinical medicine
Extracorporeal Membrane Oxygenation
medicine
Extracorporeal membrane oxygenation
Animals
Platelet
Oxygenator
Blood Coagulation
Oxygenators, Membrane
Blood Specimen Collection
business.industry
Hemodynamics
030208 emergency & critical care medicine
General Medicine
medicine.disease
Platelet Activation
Thrombosis
Disease Models, Animal
Anesthesia
Cytokines
Surgery
Inflammation Mediators
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 1873734X
- Volume :
- 51
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Accession number :
- edsair.doi.dedup.....349e215d7da3f21d08630361c594a853