29, 36, 39
Most patients on support have acquired von Willebrand syndrome. But an unknown share of the platelet abnormality belongs to the disease that made the circuit necessary, not to the circuit — the same attribution correction the free-haemoglobin data force.
Heart failure patients WITHOUT a device, and healthy donors — the design feature that makes this study useful
Lukito P, Wong A, Jing J, Arthur JF, Marasco SF, Murphy DA, Bergin PJ, Shaw JA, Collecutt M, Andrews RK, Gardiner EE, Davis AK. J Thromb Haemost 2016;14(11):2253-2260. DOI 10.1111/jth.13497
Von Willebrand multimer analysis and platelet receptor measurement (soluble and surface glycoprotein VI, surface glycoprotein Ib-alpha)
Single centre; 20 ECMO patients; cross-sectional
Loss of high-molecular-weight multimers, consistent with acquired von Willebrand syndrome, in 14 of 20 ECMO patients and 18 of 19 device patients. Elevated soluble glycoprotein VI with significantly reduced surface glycoprotein Ib-alpha and glycoprotein VI versus healthy donors. Critically, platelet receptor levels were ALSO significantly reduced in the heart failure patients who had no device.
21 continuous-flow ventricular assist device patients, 20 ECMO patients, 12 heart failure patients without a device, 7 with aortic stenosis, and healthy donors