Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study
Background: Veno venous Extra Corporeal Membrane Oxygenation (vvECMO) is associated with frequent hematological ECMO-related complications needing ECMO circuit change. Microvesicles (MVs) interplay during the thrombosis-fibrinolysis process. The main objective of the study was to identify subpopulat...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/23/7281 |
| _version_ | 1797399979535368192 |
|---|---|
| author | Christophe Guervilly Giovanni Bousquet Laurent Arnaud Ines Gragueb-Chatti Florence Daviet Mélanie Adda Jean-Marie Forel Françoise Dignat-George Laurent Papazian Antoine Roch Romaric Lacroix Sami Hraiech |
| author_facet | Christophe Guervilly Giovanni Bousquet Laurent Arnaud Ines Gragueb-Chatti Florence Daviet Mélanie Adda Jean-Marie Forel Françoise Dignat-George Laurent Papazian Antoine Roch Romaric Lacroix Sami Hraiech |
| author_sort | Christophe Guervilly |
| collection | DOAJ |
| description | Background: Veno venous Extra Corporeal Membrane Oxygenation (vvECMO) is associated with frequent hematological ECMO-related complications needing ECMO circuit change. Microvesicles (MVs) interplay during the thrombosis-fibrinolysis process. The main objective of the study was to identify subpopulations of MVs associated with indications of early vvECMO circuit change. Methods: This is a prospective observational monocenter cohort study. Blood gas was sampled on the ECMO circuit after the membrane oxygenator to measure the PO<sub>2 post oxy</sub> at inclusion, day 3, day 7 and the day of ECMO circuit removal. Blood samples for MV analysis were collected at inclusion, day 3, day 7 and the day of ECMO circuit removal. MV subpopulations were identified by flow cytometry. Results: Nineteen patients were investigated. Seven patients (37%) needed an ECMO circuit change for hemolysis (n = 4), a pump thrombosis with fibrinolysis (n = 1), persistent thrombocytopenia with bleeding (n = 1) and a decrease of O<sub>2</sub> transfer (n = 1). Levels of leukocyte and endothelial MVs were significantly higher at inclusion for patients who thereafter had an ECMO circuit change (<i>p</i> = 0.01 and <i>p</i> = 0.001). The areas under the received operating characteristics curves for LeuMVs and EndoMVs sampled the day of cannulation and the need for ECMO circuit change were 0.84 and 0.92, respectively. PO<sub>2 post oxy</sub> did not significantly change except for in one patient during the ECMO run. Conclusions: Our pilot study supports the potential interest of subpopulations of microvesicles early associated with hematological ECMO-related complications. Our results warrant further studies. |
| first_indexed | 2024-03-09T01:48:56Z |
| format | Article |
| id | doaj.art-6dc1bc6a51c64e1382bf0c8629fd706c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:48:56Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6dc1bc6a51c64e1382bf0c8629fd706c2023-12-08T15:19:08ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223728110.3390/jcm12237281Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot StudyChristophe Guervilly0Giovanni Bousquet1Laurent Arnaud2Ines Gragueb-Chatti3Florence Daviet4Mélanie Adda5Jean-Marie Forel6Françoise Dignat-George7Laurent Papazian8Antoine Roch9Romaric Lacroix10Sami Hraiech11Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceLaboratoire d’Hématologie et de Biologie Vasculaire, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceLaboratoire d’Hématologie et de Biologie Vasculaire, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, FranceCentre Hospitalier de Bastia, Service de Réanimation, 604 Chemin de Falconaja, 20600 Bastia, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceLaboratoire d’Hématologie et de Biologie Vasculaire, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, FranceAssistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, FranceBackground: Veno venous Extra Corporeal Membrane Oxygenation (vvECMO) is associated with frequent hematological ECMO-related complications needing ECMO circuit change. Microvesicles (MVs) interplay during the thrombosis-fibrinolysis process. The main objective of the study was to identify subpopulations of MVs associated with indications of early vvECMO circuit change. Methods: This is a prospective observational monocenter cohort study. Blood gas was sampled on the ECMO circuit after the membrane oxygenator to measure the PO<sub>2 post oxy</sub> at inclusion, day 3, day 7 and the day of ECMO circuit removal. Blood samples for MV analysis were collected at inclusion, day 3, day 7 and the day of ECMO circuit removal. MV subpopulations were identified by flow cytometry. Results: Nineteen patients were investigated. Seven patients (37%) needed an ECMO circuit change for hemolysis (n = 4), a pump thrombosis with fibrinolysis (n = 1), persistent thrombocytopenia with bleeding (n = 1) and a decrease of O<sub>2</sub> transfer (n = 1). Levels of leukocyte and endothelial MVs were significantly higher at inclusion for patients who thereafter had an ECMO circuit change (<i>p</i> = 0.01 and <i>p</i> = 0.001). The areas under the received operating characteristics curves for LeuMVs and EndoMVs sampled the day of cannulation and the need for ECMO circuit change were 0.84 and 0.92, respectively. PO<sub>2 post oxy</sub> did not significantly change except for in one patient during the ECMO run. Conclusions: Our pilot study supports the potential interest of subpopulations of microvesicles early associated with hematological ECMO-related complications. Our results warrant further studies.https://www.mdpi.com/2077-0383/12/23/7281veno venous ECMOECMO circuit changemicrovesiclesthrombosishemolysis |
| spellingShingle | Christophe Guervilly Giovanni Bousquet Laurent Arnaud Ines Gragueb-Chatti Florence Daviet Mélanie Adda Jean-Marie Forel Françoise Dignat-George Laurent Papazian Antoine Roch Romaric Lacroix Sami Hraiech Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study Journal of Clinical Medicine veno venous ECMO ECMO circuit change microvesicles thrombosis hemolysis |
| title | Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study |
| title_full | Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study |
| title_fullStr | Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study |
| title_full_unstemmed | Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study |
| title_short | Microvesicles Are Associated with Early Veno Venous ECMO Circuit Change during Severe ARDS: A Prospective Observational Pilot Study |
| title_sort | microvesicles are associated with early veno venous ecmo circuit change during severe ards a prospective observational pilot study |
| topic | veno venous ECMO ECMO circuit change microvesicles thrombosis hemolysis |
| url | https://www.mdpi.com/2077-0383/12/23/7281 |
| work_keys_str_mv | AT christopheguervilly microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT giovannibousquet microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT laurentarnaud microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT inesgraguebchatti microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT florencedaviet microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT melanieadda microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT jeanmarieforel microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT francoisedignatgeorge microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT laurentpapazian microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT antoineroch microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT romariclacroix microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy AT samihraiech microvesiclesareassociatedwithearlyvenovenousecmocircuitchangeduringsevereardsaprospectiveobservationalpilotstudy |