Lingel, Maximilian P. and Haus, Moritz and Paschke, Lukas and Foltan, Maik and Lubnow, Matthias and Gruber, Michael and Krenkel, Lars and Lehle, Karla (2023) Clinical relevance of cell-free DNA during venovenous extracorporeal membrane oxygenation. ARTIFICIAL ORGANS, 47 (11). pp. 1720-1731. ISSN 0160-564X, 1525-1594
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Background: Thrombosis remains a critical complication during venovenous extracorporeal membrane oxygenation (VV ECMO). The involvement of neutrophil extracellular traps (NETs) in thrombogenesis has to be discussed. The aim was to verify NETs in the form of cell-free DNA (cfDNA) in the plasma of patients during ECMO. Methods: A fluorescent DNA-binding dye (QuantifFluor((R)), Promega) was used to detect cell-free DNA in plasma samples. cfDNA concentrations from volunteers (n = 21) and patients (n = 9) were compared and correlated with clinical/technical data before/during support, ECMO end and time of a system exchange. Results: Before ECMO, patients with a median (IQR) age of 59 (51/63) years, SOFA score of 11 (10/15), and ECMO run time of 9.0 (7.0/19.5) days presented significantly higher levels of cfDNA compared to volunteers (6.4 (5.8/7.9) ng/mu L vs. 5.9 (5.4/6.3) ng/mu L; p = 0.044). Within 2 days after ECMO start, cfDNA, inflammatory, and hemolysis parameters remained unchanged, while platelets decreased (p = 0.005). After ECMO removal at the end of therapy, cfDNA, inflammation, and coagulation data (except antithrombin III) remained unchanged. The renewal of a system resulted in known alterations in fibrinogen, d-dimers, and platelets, while cfDNA remained unchanged. Conclusion: Detection of cfDNA in plasma of ECMO patients was not an indicator of acute and circuit-induced thrombogenesis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NEUTROPHIL EXTRACELLULAR TRAPS; THROMBOSIS; blood; cell-free DNA; coagulation; ECMO; inflammation; neutrophil extracellular traps |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Mar 2024 11:07 |
| Last Modified: | 07 Mar 2024 11:07 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58891 |
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