The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass
Extracorporeal life support (ECLS) has extensive applications in managing patients with acute cardiac and pulmonary failure. Two primary modalities of ECLS, cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), include several similarities in their composition, complications,...
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| Veröffentlicht in: | Artificial organs 2023-10, Vol.47 (10), p.1581-1591 |
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| creator | Malfertheiner, Maximilian V Garrett, Ashlen Passmore, Margaret Haymet, Andrew B Webb, Richard I Von Bahr, Viktor Millar, Jonathan E Schneider, Bailey A Obonyo, Nchafatso G Black, Debra Bouquet, Mahe Bartnikowski, Nicole Suen, Jacky Y Fraser, John F |
| description | Extracorporeal life support (ECLS) has extensive applications in managing patients with acute cardiac and pulmonary failure. Two primary modalities of ECLS, cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), include several similarities in their composition, complications, and patient outcomes. Both CPB and ECMO pose a high risk of thrombus formation and platelet activation due to the large surface area of the devices and bleeding due to system anticoagulation. Therefore, novel methods of anticoagulation are needed to reduce the morbidity and mortality associated with extracorporeal support. Nitric oxide (NO) has potent antiplatelet properties and presents a promising alternative or addition to anticoagulation with heparin during extracorporeal support.
We developed two ex vivo models of CPB and ECMO to investigate NO effects on anticoagulation and inflammation in these systems.
Sole addition of NO as an anticoagulant was not successful in preventing thrombus formation in the ex vivo setups, therefore a combination of low-level heparin with NO was used. Antiplatelet effects were observed in the ex vivo ECMO model when NO was delivered at 80 ppm. Platelet count was preserved after 480 min when NO was delivered at 30 ppm.
Combined delivery of NO and heparin did not improve haemocompatibility in either ex vivo model of CPB and ECMO. Anti-inflammatory effects of NO in ECMO systems have to be evaluated further. |
| doi_str_mv | 10.1111/aor.14608 |
| format | Article |
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We developed two ex vivo models of CPB and ECMO to investigate NO effects on anticoagulation and inflammation in these systems.
Sole addition of NO as an anticoagulant was not successful in preventing thrombus formation in the ex vivo setups, therefore a combination of low-level heparin with NO was used. Antiplatelet effects were observed in the ex vivo ECMO model when NO was delivered at 80 ppm. Platelet count was preserved after 480 min when NO was delivered at 30 ppm.
Combined delivery of NO and heparin did not improve haemocompatibility in either ex vivo model of CPB and ECMO. Anti-inflammatory effects of NO in ECMO systems have to be evaluated further.</description><identifier>ISSN: 0160-564X</identifier><identifier>ISSN: 1525-1594</identifier><identifier>EISSN: 1525-1594</identifier><identifier>DOI: 10.1111/aor.14608</identifier><identifier>PMID: 37395735</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Anticoagulants ; Anticoagulants - pharmacology ; Anticoagulants - therapeutic use ; Blood clots ; Cardiopulmonary Bypass - adverse effects ; Cardiopulmonary Bypass - methods ; Coagulation ; Complications ; Extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - adverse effects ; Extracorporeal Membrane Oxygenation - methods ; Heart surgery ; Heparin ; Heparin - pharmacology ; Heparin - therapeutic use ; Humans ; Inflammation ; Inflammation - etiology ; Inflammation - prevention & control ; Membranes ; Morbidity ; Nitric oxide ; Nitric Oxide - therapeutic use ; Oxygenation ; Platelets ; Thrombosis ; Thrombosis - etiology ; Thrombosis - prevention & control</subject><ispartof>Artificial organs, 2023-10, Vol.47 (10), p.1581-1591</ispartof><rights>2023 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-102d591c0b39201dfbdd607b8372a14ae3d27a1e52d0d6d67bceb7f68ad43ec43</citedby><cites>FETCH-LOGICAL-c348t-102d591c0b39201dfbdd607b8372a14ae3d27a1e52d0d6d67bceb7f68ad43ec43</cites><orcidid>0000-0002-0859-8882 ; 0000-0002-6245-2614 ; 0000-0002-5040-4359 ; 0000-0001-6511-0081</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37395735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malfertheiner, Maximilian V</creatorcontrib><creatorcontrib>Garrett, Ashlen</creatorcontrib><creatorcontrib>Passmore, Margaret</creatorcontrib><creatorcontrib>Haymet, Andrew B</creatorcontrib><creatorcontrib>Webb, Richard I</creatorcontrib><creatorcontrib>Von Bahr, Viktor</creatorcontrib><creatorcontrib>Millar, Jonathan E</creatorcontrib><creatorcontrib>Schneider, Bailey A</creatorcontrib><creatorcontrib>Obonyo, Nchafatso G</creatorcontrib><creatorcontrib>Black, Debra</creatorcontrib><creatorcontrib>Bouquet, Mahe</creatorcontrib><creatorcontrib>Bartnikowski, Nicole</creatorcontrib><creatorcontrib>Suen, Jacky Y</creatorcontrib><creatorcontrib>Fraser, John F</creatorcontrib><title>The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass</title><title>Artificial organs</title><addtitle>Artif Organs</addtitle><description>Extracorporeal life support (ECLS) has extensive applications in managing patients with acute cardiac and pulmonary failure. Two primary modalities of ECLS, cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), include several similarities in their composition, complications, and patient outcomes. Both CPB and ECMO pose a high risk of thrombus formation and platelet activation due to the large surface area of the devices and bleeding due to system anticoagulation. Therefore, novel methods of anticoagulation are needed to reduce the morbidity and mortality associated with extracorporeal support. Nitric oxide (NO) has potent antiplatelet properties and presents a promising alternative or addition to anticoagulation with heparin during extracorporeal support.
We developed two ex vivo models of CPB and ECMO to investigate NO effects on anticoagulation and inflammation in these systems.
Sole addition of NO as an anticoagulant was not successful in preventing thrombus formation in the ex vivo setups, therefore a combination of low-level heparin with NO was used. Antiplatelet effects were observed in the ex vivo ECMO model when NO was delivered at 80 ppm. Platelet count was preserved after 480 min when NO was delivered at 30 ppm.
Combined delivery of NO and heparin did not improve haemocompatibility in either ex vivo model of CPB and ECMO. Anti-inflammatory effects of NO in ECMO systems have to be evaluated further.</description><subject>Anticoagulants</subject><subject>Anticoagulants - pharmacology</subject><subject>Anticoagulants - therapeutic use</subject><subject>Blood clots</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Coagulation</subject><subject>Complications</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - adverse effects</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Heart surgery</subject><subject>Heparin</subject><subject>Heparin - pharmacology</subject><subject>Heparin - therapeutic use</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inflammation - etiology</subject><subject>Inflammation - prevention & control</subject><subject>Membranes</subject><subject>Morbidity</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - therapeutic use</subject><subject>Oxygenation</subject><subject>Platelets</subject><subject>Thrombosis</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - prevention & control</subject><issn>0160-564X</issn><issn>1525-1594</issn><issn>1525-1594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9LHDEYh4NU3O22h36BEuilHkbzdzJ7LGJtQfCi4G3IJO9ss0ySaTIju5_Cr2x0bQVzSQgPD7_3_SH0hZIzWs65jumMipo0R2hJJZMVlWvxAS0JrUkla3G_QB9z3hJClCD1CVpwxddScblEj7d_AEPfg5kyjj0ObkrO4LhzFnAM2ES9mQc9ufLWwWIX-kF7f_hwAcMOP7iHiH20MLwYYDclbWIaYwI9YA--SzoU2W6_gfBmMjpZF8d58DHotMfdftQ5f0LHvR4yfH69V-ju5-Xtxa_q-ubq98WP68pw0UwVJczKNTWk42tGqO07a2uiuoYrpqnQwC1TmoJkltja1qoz0Km-brQVHIzgK_T94B1T_DtDnlrvsoFhKFHjnFvWcNYIpggt6Ld36DbOKZR0hWoYa2RZd6FOD5RJMecEfTsm58tgLSXtc0ttaal9aamwX1-Nc-fB_if_1cKfACqnkF8</recordid><startdate>202310</startdate><enddate>202310</enddate><creator>Malfertheiner, Maximilian V</creator><creator>Garrett, Ashlen</creator><creator>Passmore, Margaret</creator><creator>Haymet, Andrew B</creator><creator>Webb, Richard I</creator><creator>Von Bahr, Viktor</creator><creator>Millar, Jonathan E</creator><creator>Schneider, Bailey A</creator><creator>Obonyo, Nchafatso G</creator><creator>Black, Debra</creator><creator>Bouquet, Mahe</creator><creator>Bartnikowski, Nicole</creator><creator>Suen, Jacky Y</creator><creator>Fraser, John F</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0859-8882</orcidid><orcidid>https://orcid.org/0000-0002-6245-2614</orcidid><orcidid>https://orcid.org/0000-0002-5040-4359</orcidid><orcidid>https://orcid.org/0000-0001-6511-0081</orcidid></search><sort><creationdate>202310</creationdate><title>The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass</title><author>Malfertheiner, Maximilian V ; Garrett, Ashlen ; Passmore, Margaret ; Haymet, Andrew B ; Webb, Richard I ; Von Bahr, Viktor ; Millar, Jonathan E ; Schneider, Bailey A ; Obonyo, Nchafatso G ; Black, Debra ; Bouquet, Mahe ; Bartnikowski, Nicole ; Suen, Jacky Y ; Fraser, John F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-102d591c0b39201dfbdd607b8372a14ae3d27a1e52d0d6d67bceb7f68ad43ec43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anticoagulants</topic><topic>Anticoagulants - pharmacology</topic><topic>Anticoagulants - therapeutic use</topic><topic>Blood clots</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Coagulation</topic><topic>Complications</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Extracorporeal Membrane Oxygenation - adverse effects</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Heart surgery</topic><topic>Heparin</topic><topic>Heparin - pharmacology</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Inflammation - etiology</topic><topic>Inflammation - prevention & control</topic><topic>Membranes</topic><topic>Morbidity</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - therapeutic use</topic><topic>Oxygenation</topic><topic>Platelets</topic><topic>Thrombosis</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Malfertheiner, Maximilian V</creatorcontrib><creatorcontrib>Garrett, Ashlen</creatorcontrib><creatorcontrib>Passmore, Margaret</creatorcontrib><creatorcontrib>Haymet, Andrew B</creatorcontrib><creatorcontrib>Webb, Richard I</creatorcontrib><creatorcontrib>Von Bahr, Viktor</creatorcontrib><creatorcontrib>Millar, Jonathan E</creatorcontrib><creatorcontrib>Schneider, Bailey A</creatorcontrib><creatorcontrib>Obonyo, Nchafatso G</creatorcontrib><creatorcontrib>Black, Debra</creatorcontrib><creatorcontrib>Bouquet, Mahe</creatorcontrib><creatorcontrib>Bartnikowski, Nicole</creatorcontrib><creatorcontrib>Suen, Jacky Y</creatorcontrib><creatorcontrib>Fraser, John F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malfertheiner, Maximilian V</au><au>Garrett, Ashlen</au><au>Passmore, Margaret</au><au>Haymet, Andrew B</au><au>Webb, Richard I</au><au>Von Bahr, Viktor</au><au>Millar, Jonathan E</au><au>Schneider, Bailey A</au><au>Obonyo, Nchafatso G</au><au>Black, Debra</au><au>Bouquet, Mahe</au><au>Bartnikowski, Nicole</au><au>Suen, Jacky Y</au><au>Fraser, John F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass</atitle><jtitle>Artificial organs</jtitle><addtitle>Artif Organs</addtitle><date>2023-10</date><risdate>2023</risdate><volume>47</volume><issue>10</issue><spage>1581</spage><epage>1591</epage><pages>1581-1591</pages><issn>0160-564X</issn><issn>1525-1594</issn><eissn>1525-1594</eissn><abstract>Extracorporeal life support (ECLS) has extensive applications in managing patients with acute cardiac and pulmonary failure. Two primary modalities of ECLS, cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), include several similarities in their composition, complications, and patient outcomes. Both CPB and ECMO pose a high risk of thrombus formation and platelet activation due to the large surface area of the devices and bleeding due to system anticoagulation. Therefore, novel methods of anticoagulation are needed to reduce the morbidity and mortality associated with extracorporeal support. Nitric oxide (NO) has potent antiplatelet properties and presents a promising alternative or addition to anticoagulation with heparin during extracorporeal support.
We developed two ex vivo models of CPB and ECMO to investigate NO effects on anticoagulation and inflammation in these systems.
Sole addition of NO as an anticoagulant was not successful in preventing thrombus formation in the ex vivo setups, therefore a combination of low-level heparin with NO was used. Antiplatelet effects were observed in the ex vivo ECMO model when NO was delivered at 80 ppm. Platelet count was preserved after 480 min when NO was delivered at 30 ppm.
Combined delivery of NO and heparin did not improve haemocompatibility in either ex vivo model of CPB and ECMO. Anti-inflammatory effects of NO in ECMO systems have to be evaluated further.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37395735</pmid><doi>10.1111/aor.14608</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0859-8882</orcidid><orcidid>https://orcid.org/0000-0002-6245-2614</orcidid><orcidid>https://orcid.org/0000-0002-5040-4359</orcidid><orcidid>https://orcid.org/0000-0001-6511-0081</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anticoagulants Anticoagulants - pharmacology Anticoagulants - therapeutic use Blood clots Cardiopulmonary Bypass - adverse effects Cardiopulmonary Bypass - methods Coagulation Complications Extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - adverse effects Extracorporeal Membrane Oxygenation - methods Heart surgery Heparin Heparin - pharmacology Heparin - therapeutic use Humans Inflammation Inflammation - etiology Inflammation - prevention & control Membranes Morbidity Nitric oxide Nitric Oxide - therapeutic use Oxygenation Platelets Thrombosis Thrombosis - etiology Thrombosis - prevention & control |
| title | The effects of nitric oxide on coagulation and inflammation in ex vivo models of extracorporeal membrane oxygenation and cardiopulmonary bypass |
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