Endothelial Activation and Permeability in Patients on VV-ECMO Support: An Exploratory Study
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Le résumé fourni par la source
Background Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports critically ill patients with respiratory failure. However, ECMO may induce systemic inflammation, hemolysis, and hemodilution, potentially resulting in endothelial activation and damage. Therefore, this study explored the longitudinal changes in circulating markers of inflammation, hemolysis, and endothelial activation and damage in patients with COVID-19 on VV-ECMO. Methods Plasma was obtained before, within 48 h as well as on day 4, week 1, and week 2 of ECMO support and after decannulation. Circulating markers were measured using Luminex, ELISA, and spectrophotometry. Human pulmonary endothelial cells were exposed to patient plasma, and in vitro endothelial permeability was assessed using electric cell-substrate impedance sensing. Results From April 2020 to January 2022, plasma was collected from 14 patients (71.4% male; age 54 (45–61) years). IL-6 levels decreased (1.238 vs. 0.614 ng/mL, p = 0.039) while ICAM-1 increased (667 vs. 884 ng/mL, p = 0.003) over time when compared to pre-ECMO. Angiopoietin-1 decreased after ECMO initiation (7.57 vs. 3.58 ng/mL, p = 0.030), whereas angiopoietin-2 increased (5.20 vs. 10.19 ng/mL, p = 0.017), particularly in non-survivors of ECMO. Cell-free hemoglobin decreased directly after VV-ECMO initiation but remained stable thereafter (55.29 vs. 9.19 mg/dL, p = 0.017). Moreover, the plasma obtained at several time points during the ECMO run induced in vitro pulmonary endothelial hyperpermeability. Conclusions This exploratory study shows that patients on VV-ECMO support due to COVID-ARDS exhibit progressive endothelial activation and damage but not inflammation and hemolysis. Larger prospective studies are necessary to elucidate pathophysiological pathways leading to endothelial activation and damage, thereby reducing organ failure in these critically ill patients.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Endothelial Activation and Permeability in Patients on VV-ECMO Support: An Exploratory Study
- Date Crossref
- 09/07/2025
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Amsterdam University Medical Centers pays non établi dans la noticeÉtablissement de santé
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University of Amsterdam Department of Intensive Care Medicine pays non établi dans la noticeUniversité ou école supérieure
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Institute of Infection and Immunity pays non établi dans la noticeStructure de recherche
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Amsterdam Neuroscience pays non établi dans la noticeStructure de recherche
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Amsterdam University of Applied Sciences pays non établi dans la noticeUniversité ou école supérieure
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VU University Department of Anesthesiology pays non établi dans la noticeUniversité ou école supérieure
Amsterdam University Medical Centers, Department of Intensive Care Medicine — University of Amsterdam et Institute of Infection and Immunity, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.