ArticleCritical care (London, England)2024
Blood trauma in veno-venous extracorporeal membrane oxygenation: low pump pressures and low circuit resistance matter.
Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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Who cites it
9 citing papers in PubMed.
- Extracorporeal COCritical care (London, England) · 2026Trial
- 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
- An Optimized Multi-Stage Drainage Cannula Design for Venoarterial Extracorporeal Membrane Oxygenation.Artificial organs · 2026Article
- Haemolytic injury and cardiovascular disease.Nature reviews. Cardiology · 2026Review
- Protruding Objects in the Membrane Lung Outlet May Increase Thrombogenicity: Fluid Dynamical Insights.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2026Article
- High-Caliber Femoral Dual-Lumen Cannula for ECCO 2 R in Hypercapnic Respiratory Failure: Efficacy and Safety Evaluation.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2026Article
- [Design of a benchmark pump model and optimization of hemolysis testing protocol for evaluation of blood pump hemocompatibility].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2026Article
- Article
- Predictive Potential of ECMO Blood Flow for Hemolysis and Outcome of Patients with Severe ARDS.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundVeno-venous extracorporeal membrane oxygenation (VV ECMO) has become standard of care in patients with the most severe forms of acute respiratory distress syndrome. However, hemolysis and bleeding are one of the most frequent side effects, affecting mortality. Despite the widespread use of VV ECMO, current protocols lack detailed, in-vivo data-based recommendations for safe ECMO pump operating conditions. This study aims to comprehensively analyze the impact of VV ECMO pump operating conditions on hemolysis by combining in-silico modeling and clinical data analysis.
methodsWe combined data from 580 patients treated with VV ECMO in conjunction with numerical predictions of hemolysis using computational fluid dynamics and reduced order modeling of the Rotaflow (Getinge) and DP3 (Xenios) pumps. Blood trauma parameters across 94,779 pump operating points were associated with numerical predictions of shear induced hemolysis.
resultsMinimal hemolysis was observed at low pump pressures and low circuit resistance across all flow rates, whereas high pump pressures and circuit resistance consistently precipitated substantial hemolysis, irrespective of flow rate. However, the lower the flow rate, the more pronounced the influence of circuit resistance on hemolysis became. Numerical models validated against clinical data demonstrated a strong association (Spearman's r = 0.8) between simulated and observed hemolysis, irrespective of the pump type.
conclusionsIntegrating in-silico predictions with clinical data provided a novel approach in understanding and potentially reducing blood trauma in VV ECMO. This study further demonstrated that a key factor in lowering side effects of ECMO support is the maintenance of low circuit resistance, including oxygenators with the lowest possible resistance, the shortest feasible circuit tubing, and cannulae with an optimal diameter.
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