ArticleIntensive care medicine experimental2019
Low flow rate alters haemostatic parameters in an ex-vivo extracorporeal membrane oxygenation circuit.
Article in Intensive care medicine experimental, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06938217 (Safety and Efficacy of Low-Flow ECMO in a Multi-modal Cohort of Adults in Respiratory Failure), which is not on this map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety and Efficacy of Low-Flow ECMO in a Multi-modal Cohort of Adults in Respiratory Failure
Who cites it
25 citing papers in PubMed, 71 citations in OpenAlex.
- Impact of side hole design of drainage cannulas on flow velocity and predilection sites for low-flow areas in veno-venous ECMO circuits.Intensive care medicine experimental · 2026Article
- Challenges and opportunities in ECMO monitoring: A mixed-methods appraisal.The journal of extra-corporeal technology · 2026Review
- Cannula-Associated Deep Vein Thrombosis After Extracorporeal Life Support: A Prospective Diagnostic Study.Journal of clinical medicine · 2025Article
- ECMO-induced coagulopathy: strategic initiatives for research and clinical practice (a workshop report of the NHLBI).Blood vessels, thrombosis & hemostasis · 2025Review
- Impact of extracorporeal blood pump gap sizes on the performance and hemocompatibility under off-design operation.Artificial organs · 2025Article
- Critical hematological parameters in bleeding during extracorporeal membrane oxygenation support.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- The relationship between different anticoagulation monitoring indicators and heparin doses in adult patients with extracorporeal cardiopulmonary resuscitation.Frontiers in cardiovascular medicine · 2025Article
- Blood trauma in veno-venous extracorporeal membrane oxygenation: low pump pressures and low circuit resistance matter.Critical care (London, England) · 2024Article
- Thrombocytopenia risks in ARDS COVID-19 patients treated with high-dose linezolid during vvECMO therapy: an observational study.Naunyn-Schmiedeberg's archives of pharmacology · 2024Observational
- Platelet Adhesion and Activation in an ECMO Thrombosis-on-a-Chip Model.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Preclinical Proof-of-Concept of a Minimally Invasive Direct Cardiac Compression Device for Pediatric Heart Support.Cardiovascular engineering and technology · 2024Article
- Predictors of thrombosis during VV ECMO: an analysis of 9809 patients from the ELSO registry.Journal of thrombosis and thrombolysis · 2024Article
- Development of a Carbon Nanotube-Enhanced FAS Bilayer Amphiphobic Coating for Biological Fluids.Nanomaterials (Basel, Switzerland) · 2023Article
- Review
- Haematological Trends and Transfusion during Adult Extracorporeal Membrane Oxygenation: A Single Centre Study.Journal of clinical medicine · 2023Article
- Effects of varying blood flow rate during peripheral veno-arterial extracorporeal membrane oxygen (V-A ECMO) on left ventricular function measured by two-dimensional strain.Frontiers in cardiovascular medicine · 2023Article
- A numerical study of the hemodynamic behavior and gas transport in cardiovascular systems with severe cardiac or cardiopulmonary failure supported by venoarterial extracorporeal membrane oxygenation.Frontiers in bioengineering and biotechnology · 2023Article
- Anticoagulation Strategies during Extracorporeal Membrane Oxygenation: A Narrative Review.Journal of clinical medicine · 2022Review
- Echocardiography for extracorporeal membrane oxygenation.Echocardiography (Mount Kisco, N.Y.) · 2022Review
- Extracorporeal Membrane Oxygenation-Induced Hemolysis: An In Vitro Study to Appraise Causative Factors.Membranes · 2021Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundExtracorporeal membrane oxygenation (ECMO) is a life-saving modality used to manage cardiopulmonary failure refractory to conventional medical and surgical therapies. Despite advances in ECMO equipment, bleeding and thrombosis remain significant complications. While the flow rate for ECMO support is well recognized, less is known about the minimum-rate requirements and haemostasis. We investigated the relationship between different ECMO flow rates, and their effect on haemolysis and coagulation.
methodsTen ex-vivo ECMO circuits were tested using donated, < 24-h-old human whole blood, with two flow rates: high-flow at 4 L/min (normal adult cardiac output; n = 5) and low-flow at 1.5 L/min (weaning; n = 5). Serial blood samples were taken for analysis of haemolysis, von Willebrand factor (vWF) multimers by immunoblotting, rotational thromboelastometry, platelet aggregometry, flow cytometry and routine coagulation laboratory tests.
resultsLow-flow rates increased haemolysis after 2 h (p = 0.02), 4 h (p = 0.02) and 6 h (p = 0.02) and the loss of high-molecular-weight vWF multimers (p = 0.01), while reducing ristocetin-induced platelet aggregation (p = 0.0002). Additionally, clot formation times were prolonged (p = 0.006), with a corresponding decrease in maximum clot firmness (p = 0.006).
conclusionsIn an ex-vivo model of ECMO, low-flow rate (1.5 L/min) altered haemostatic parameters compared to high-flow (4 L/min). Observed differences in haemolysis, ristocetin-induced platelet aggregation, high-molecular-weight vWF multimers and clot formation time suggest an increased risk of bleeding complications. Since patients are often on ECMO for protracted periods, extended-duration studies are required to characterise long-term ECMO-induced haemostatic changes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.