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

Mellgren, Karin,1962Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics (author)

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.

Friberg, L G (author)
Hedner, Thomas,1949Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för klinisk farmakologi,Institute of Internal Medicine, Dept of Clinical Pharmacology(Swepub:gu)xhedto (author)
Mellgren, G (author)
Wadenvik, Hans,1955Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för internmedicin,Institute of Internal Medicine, Dept of Medicine(Swepub:gu)xwadha (author)
Göteborgs universitetInstitutionen för kvinnors och barns hälsa, Avdelningen för pediatrik (creator_code:org_t)

By the author/editor: Mellgren, Karin, ...; Friberg, L G; Hedner, Thomas, ...; Mellgren, G; Wadenvik, Hans, ...

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