Changes in Red Blood Cell Properties and Platelet Function during Extracorporeal Membrane Oxygenation

Annemieke Oude Lansink-Hartgring*, Roland Hoffmann, Walter van den Bergh, Adrianus de Vries

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

28 Downloads (Pure)


Extracorporeal membrane oxygenation (ECMO) is associated with frequent hemorrhagic and thromboembolic complications. The multiple effects of ECMO include inflammatory response on contact with the circuit; hemolysis acquired von Willebrand syndrome likely affects the function of red blood cells (RBC) and platelets. The aim of this prospective observational study was to analyze RBC aggregation and elongation (deformability) and platelet aggregation in the first week of ECMO. Sixteen patients were included. Blood samples were taken prior to initiation of ECMO and on days 1, 2, 3, 5, and 7. RBC aggregation and elongation were analyzed using the laser-assisted optical rotational red cell analyzer (Lorrca). Upstroke, top, and amplitude as indices of aggregation showed significant time effects. RBC elongation was not affected at low shear stress. At high shear stress there was an increase in the elongation index at day 2 (p = 0.004), followed by a decrease. Platelet function was analyzed using multiple electrode aggregometry (Multiplate((R))). In pairwise comparison in the days 1-7 to the value prior to ECMO there was no significant difference in platelet aggregation by any of the three agonists (ADP p = 0.61; TRAP p = 0.77; Ristocetin p = 0.25). This implies that the rheology of RBCs seemed to be more affected by ECMO than platelets. Especially the red blood cell deformability continues to decline at higher shear stress.

Original languageEnglish
Article number1168
Number of pages11
JournalJournal of Clinical Medicine
Issue number4
Publication statusPublished - Apr-2020


  • extracorporeal membrane oxygenation
  • bleeding
  • platelet function

Cite this