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Clot formation within membrane oxygenators (MOs) remains a critical problem during extracorporeal membrane oxygenation (ECMO). The composition of the clots—in particular, the presence of von Willebrand factor (vWF)—may be an indicator for prevalent nonphysiological flow conditions, foreign body reactions, or coagulation abnormalities in critically ill patients. Mats of interwoven gas exchange fibers from randomly collected MOs (PLS, Maquet, Rastatt, Germany) of 21 patients were stained with antibodies (anti‐vWF and anti‐P‐selectin) and counterstained with 4′,6‐diamidino‐2‐phenylindole. The extent of vWF‐loading was correlated with patient and technical data. While 12 MOs showed low vWF‐loadings, 9 MOs showed high vWF‐loading with highest accumulations close to crossing points of adjacent gas fibers. The presence and the extent of vWF‐fibers/“cobwebs,” leukocytes, platelet–leukocyte aggregates (PLAs), and P‐selectin‐positive platelet aggregates were independent of the extent of vWF‐loading. However, the highly loaded MOs were obtained from patients with a significantly elevated SOFA score, severe thrombocytopenia, and persistent liver dysfunction. The coagulation abnormalities of these critically ill patients may cause an accumulation of the highly thrombogenic and elongated high‐molecular‐weight vWF multimers in the plasma which will be trapped in the MOs during the ECMO therapy.
Migration and Statistics
(2009)
The field of empirical migration and integration research is characterised by a wide range of research questions, theoretical approaches and data sets. Research based on official statistics has to deal with different data sets on migration and foreign population resulting in different numbers. Developments in official statistics concentrate on the improvement of data quality. The census 2010/2011 or the projected central population register are important issues, e.g. in respect of sampling and weighting of migrants in surveys. The concept of migration background in the microcensus is a mayor enhancement in population statistics and has become widely accepted. It is recommended to implement questions on migration background in the census 2010/2011 too. The most important accessible data sets in the field of empirical integration research are the microcensus and the German Socio-Economic Panel; there is still untapped potential for analysis in this area. The supplementation of large surveys with a migrant sample is an appreciated trend. Most important challenges for empirical migration and integration research are the development of sampling methods for migrant population (including onomastics and topomastics), studies on new and small migrant groups, research projects in the country of origin, longitudinal migrant surveys and the development of measurement instruments.