Blood platelet activation and membrane glycoprotein changes during extracorporeal life support (ECLS). In vitro studies.

• The aim of this study was to evaluate an in vitro model for investigation of platelet function parameters in an extracorporeal system. Two different perfusion pumps were compared, a roller pump (Polystan) and a centrifugal pump (Biomedicus). A continuous increase in glycoprotein (GP)1b-negative platelets was observed in both circuits. A marked increase of plasma beta-thromboglobulin thromboglobulin concentration and a decrease of the intracellular pool of serotonin was observed, indicating a marked release of alpha as well as of dense granules. The plasma concentration of glycocalicin increased in parallel with a reduced platelet surface expression of GP1b, suggesting that the loss of GP1b is caused by proteolysis rather than by a downregulation of this receptor protein. It is concluded that ECLS results in a pronounced platelet degranulation and causes changes of important membrane receptors which might explain some of the bleeding problems observed in patients treated with ECLS. No significant difference was noted between the roller pump and the centrifugal pump. Trial of strategies, e.g., protease inhibitors and nitric oxide to revert this untoward effect of ECLS are highly warranted.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Artificial Organs

Centrifugation

adverse effects

Extracorporeal Circulation

adverse effects

instrumentation

Hemoglobins

analysis

Humans

Platelet Activation

Platelet Count

Platelet Glycoprotein GPIb-IX Complex

analysis

Platelet Membrane Glycoproteins

analysis

Serotonin

blood

beta-Thromboglobulin

analysis

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)