Clinical relevance of cell-free DNA during venovenous extracorporeal membrane oxygenation

  • 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®, 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/μL vs. 5.9 (5.4/6.3) ng/μL; 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.

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Author:Maximilian P. Lingel, Moritz Haus, Lukas Paschke, Maik Foltan, Matthias Lubnow, Michael Gruber, Lars KrenkelORCiDGND, Karla LehleORCiD
DOI:https://doi.org/10.1111/aor.14616
ISSN:1525-1594
Parent Title (English):Artificial organs
Publisher:Wiley
Document Type:Article
Language:English
Year of first Publication:2023
Release Date:2023/11/20
Tag:ECMO; blood; cell- free DNA; coagulation; inflammation; neutrophil extracellular traps
Volume:47
Issue:11
First Page:1720
Last Page:1731
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Regensburg Center of Health Sciences and Technology - RCHST
Fakultät Maschinenbau / Labor Biofluidmechanik
Begutachtungsstatus:peer-reviewed
research focus:Lebenswissenschaften und Ethik
OpenAccess Publikationsweg:Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium
Licence (German):Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International