ArticleJournal of thrombosis and haemostasis : JTH2020
Effect of blood flow on platelets, leukocytes, and extracellular vesicles in thrombosis of simulated neonatal extracorporeal circulation.
Article in Journal of thrombosis and haemostasis : JTH, 2020. 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, 3 of them syntheses that pooled it.
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, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Tiny messengers, big impact: unlocking the power of extracellular vesicles in neonatal health and disease. a systematic review.Frontiers in immunology · 2026Pooled it
- Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024Pooled it
- Exercise and Circulating Microparticles in Healthy Subjects.Journal of cardiovascular translational research · 2021Pooled it
- Prolonged Extracorporeal Membrane Oxygenation Without Systemic Anticoagulation in Sheep.Annals of biomedical engineering · 2026Article
- Considerations and future challenges in managing ECMO for pediatric patients.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Review
- Article
- Venous thrombosis unchained: Pandora's box of noninflammatory mechanisms.Blood advances · 2025Review
- Prothrombotic Microvesicle Generation in Pediatric Cardiopulmonary Bypass: A Pilot Observational Study.Critical care explorations · 2025Observational
- Comparative study of flow rate- and material-dependent human plasma protein adsorption on oxygenator membranes and heat exchanger materials.Frontiers in cardiovascular medicine · 2025Article
- Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal.Journal of clinical medicine · 2024Review
- Heparin Resistance in Patients Receiving Extracorporeal Membrane Oxygenation: A Review.Journal of clinical medicine · 2024Review
- The Role of Extracorporeal Membrane Oxygenation ECMO in Accidental Hypothermia and Rewarming in Out-of-Hospital Cardiac Arrest Patients-A Literature Review.Journal of clinical medicine · 2023Review
- Current and future strategies to monitor and manage coagulation in ECMO patients.Thrombosis journal · 2023Review
- Therapeutics of Extracellular Vesicles in Cardiocerebrovascular and Metabolic Diseases.Advances in experimental medicine and biology · 2023Article
- Thrombus formation during ECMO: Insights from a detailed histological analysis of thrombus composition.Journal of thrombosis and haemostasis : JTH · 2022Article
- Insights Into the Low Rate of In-Pump Thrombosis With the HeartMate 3: Does the Artificial Pulse Improve Washout?Frontiers in cardiovascular medicine · 2022Article
- Intervention to severe lower trachea obstruction supported by extracorporeal membrane oxygenation in a human immunodeficiency virus patient: A case report and literature review.Frontiers in medicine · 2022Article
- Clinical use of thrombin generation assays.Journal of thrombosis and haemostasis : JTH · 2021Review
- Blood cell-derived extracellular vesicles: diagnostic biomarkers and smart delivery systems.Bioengineered · 2021Article
- Critical role of oxidized LDL receptor-1 in intravascular thrombosis in a severe influenza mouse model.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundExtracorporeal membrane oxygenation (ECMO) has frequent and sometimes lethal thrombotic complications. The role that activated platelets, leukocytes, and small (0.3-micron to 1-micron) extracellular vesicles (EVs) play in ECMO thrombosis is not well understood.
objectivesTo test the effect of blood flow rate on the generation of activated platelets, leukocytes, and EVs in a simulated neonatal ECMO circuit using heparinized human whole blood.
methodsSimulated neonatal roller pump circuits circulated whole blood at low, nominal, and high flow rates (0.3, 0.5, and 0.7 L/min) for 6 h. Coagulopathy was defined by thromboelastography (TEG), STA
resultsDespite heparinization, occlusive thrombosis halted flow in two of five circuits at 0.3 L/min and three of five circuits at 0.7 L/min. None of the five circuits at 0.5 L/min exhibited occlusive thrombosis. Phosphatidylserine (PS)-positive platelets and EVs increased at all flow rates more than blood under static conditions (P < .0002). Tissue factor (TF)-positive leukocytes and EVs increased only in low-flow and high-flow circuits (P < .0001). Tissue factor pathway inhibitor (TFPI), at 50 times more than the concentration in healthy adults, failed to suppress thrombin initiation in low-flow and high-flow circuits.
conclusionsThis in vitro study informs ECMO specialists to avoid low and high blood flow that increases TF expression on leukocytes and EVs, which likely initiate clot formation. Interventions to decrease TF generated by ECMO may be an effective approach to decrease thrombosis.
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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.