TY - JOUR A1 - Haus, Moritz A1 - Foltan, Maik A1 - Philipp, Alois A1 - Müller, Thomas A1 - Lingel, Maximilian P. A1 - Krenkel, Lars A1 - Gruber, Michael A1 - Lehle, Karla T1 - Neutrophil extracellular traps -a potential trigger for the development of thrombocytopenia during extracorporeal membrane oxygenation N2 - Neutrophil extracellular traps (NETs) have recently emerged as a potential link between inflammation, immunity, and thrombosis, as well as other coagulation disorders which present a major challenge in the context of extracorporeal membrane oxygenation (ECMO). By examining blood from ECMO patients for NETs and their precursors and correlating them with clinical and laboratory biomarkers of coagulation and inflammation, this study aims to evaluate the association between the presence of NETs in the bloodstream of ECMO patients and the development of potentially severe coagulation disorders during ECMO therapy. Therefore, blood samples were collected from healthy volunteers (n=13) and patients receiving veno-venous (VV) ECMO therapy (n=10). To identify NETs and their precursors, DNA and myeloperoxidase as well as granulocyte marker CD66b were visualized simultaneously by immunofluorescence staining in serial blood smears. Differentiation of DNA-containing objects and identification of NETs and their precursors was performed semiautomatically by a specific algorithm using the shape and size of DNA staining and the intensity of MPO and CD66b signal. Neutrophil extracellular traps and their precursors could be detected in blood smears from patients requiring VV ECMO. Compared to volunteers, ECMO patients presented significantly higher rates of NETs and NET precursors as well as an increased proportion of neutrophil granulocytes in all detected nucleated cells. A high NET rate prior to the initiation of ECMO therapy was associated with both increased iL-6 and TNF-α levels as an expression of a high cytokine burden. These patients with increased NET release also presented an earlier and significantly more pronounced decrease in platelet counts and ATIII activity following initiation of therapy compared with patients with less elevated NETs. These findings provide further indications for the development of immune-mediated acquired thrombocytopenia in ECMO patients. KW - Neutrophil extracellular traps (NET) KW - Immunoflorescence KW - Thrombocytopenia KW - Extracorporeal membrane oxygenation (ECMO) KW - Sepsis KW - immunothrombosis KW - Coagulation disorder Y1 - 2024 UR - https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1339235/abstract U6 - https://doi.org/10.3389/fimmu.2024.1339235 VL - 15 PB - frontiers ER - TY - JOUR A1 - Klein, C. A1 - Nabbefeld, T. A1 - Hattab, H. A1 - Meyer, D. A1 - Jnawali, G. A1 - Kammler, Martin A1 - Meyer zu Heringdorf, Frank-Joachim A1 - Golla-Franz, A. A1 - Müller, B. H. A1 - Schmidt, Thomas A1 - Henzler, M. A1 - Horn-von Hoegen, Michael T1 - Lost in reciprocal space? Determination of the scattering condition in spot profile analysis low-energy electron diffraction JF - Review of scientific instruments N2 - The precise knowledge of the diffraction condition, i.e., the angle of incidence and electron energy, is crucial for the study of surface morphology through spot profile analysis low-energy electron diffraction (LEED). We demonstrate four different procedures to determine the diffraction condition: employing the distortion of the LEED pattern under large angles of incidence, the layer-by-layer growth oscillations during homoepitaxial growth, a G(S) analysis of a rough surface, and the intersection of facet rods with 3D Bragg conditions. Y1 - 2011 U6 - https://doi.org/10.1063/1.3554305 VL - 82 IS - 3 PB - American Institute of Physics ER - TY - JOUR A1 - Lehle, Karla A1 - Philipp, Alois A1 - Krenkel, Lars A1 - Gruber, Michael A1 - Hiller, Karl-Anton A1 - Müller, Thomas A1 - Lubnow, Matthias T1 - Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia JF - ASAIO Journal N2 - Contact of blood with artificial surfaces triggers platelet activation. The aim was to compare platelet kinetics after venovenous extracorporeal membrane oxygenation (V-V ECMO) start and after system exchange in different etiologies of acute lung failure. Platelet counts and coagulation parameters were analyzed from adult patients with long and exchange-free (≥8 days) ECMO runs (n = 330) caused by bacterial (n = 142), viral (n = 76), or coronavirus disease 2019 (COVID-19) (n = 112) pneumonia. A subpopulation requiring a system exchange and with long, exchange-free runs of the second oxygenator (≥7 days) (n = 110) was analyzed analogously. Patients with COVID-19 showed the highest platelet levels before ECMO implantation. Independent of the underlying disease and ECMO type, platelet counts decreased significantly within 24 hours and reached a steady state after 5 days. In the subpopulation, at the day of a system exchange, platelet counts were lower compared with ECMO start, but without differences between underlying diseases. Subsequently, platelets remained unchanged in the bacterial pneumonia group, but increased in the COVID-19 and viral pneumonia groups within 2–4 days, whereas D-dimers decreased and fibrinogen levels increased. Thus, overall platelet counts on V-V ECMO show disease-specific initial dynamics followed by an ongoing consumption by the ECMO device, which is not boosted by new artificial surfaces after a system exchange. Y1 - 2025 U6 - https://doi.org/10.1097/MAT.0000000000002383 SN - 1058-2916 SN - 1538-943X PB - Wolters Kluwer ER - TY - GEN A1 - Kranz, Michael A1 - Wagner, Maria Stella A1 - Pointner, Daniel A1 - Waldbauer, Selina A1 - Müller, Thomas A1 - Lubnow, Matthias A1 - Foltan, Maik A1 - Krenkel, Lars A1 - Lehle, Karla T1 - Polymeric Embedding of Membrane Lungs: A Novel Method for Histological Investigations of Intra-Device Clot Formation T2 - 12th EuroELSO Congress, 24-27. April 2024, Krakow Y1 - 2024 ER - TY - GEN A1 - Kranz, Michael A1 - Wagner, Maria Stella A1 - Krenkel, Lars A1 - Müller, Thomas A1 - Lubnow, Matthias A1 - Philipp, Alois A1 - Lehle, Karla T1 - Clot Localization within Membrane Lungs using different Imaging Methods and Histological Clot Characterization as a way to prevent Thrombosis in Extracorporeal Membrane Oxygenation Y1 - 2023 VL - 2023 ER - TY - GEN A1 - Köster, Leonie A1 - Kranz, Michael A1 - Wagner, Maria Stella A1 - Foltan, Maik A1 - Müller, Thomas A1 - Lubnow, Matthias A1 - Krenkel, Lars A1 - Lehle, Karla T1 - Histological Investigations of Intra-Device Clot Formation in ECMO Pumps T2 - 12th EuroELSO Congress, 24-27. April 2024, Krakow Y1 - 2024 ER -