The Annals of Thoracic Surgery, Vol 53, 1046-1051, Copyright © 1992 by The Society of Thoracic Surgeons
Twenty-four-hour heparin-free veno-right ventricular ECMO: an experimental study
B Koul, O Vesterqvist, N Egberg and S Steen
Thoracic Surgical Clinic, University Hospital, Lund, Sweden.
Platelets and coagulation factors were studied during 24-hour heparin- free
veno-right ventricular extracorporeal membrane oxygenation (ECMO) in 6
healthy pigs. An endpoint attached and covalently bonded heparin- coated
ECMO system was used in these experiments. The veno-right ventricular ECMO
supplied the total lung function of the animals, and after 24 hours, all
the animals were successfully weaned from ECMO. Lung function and central
hemodynamics were not affected by the procedure. Because all the animals
showed a significant reduction in plasma volume, the concentration of
measured coagulation variables was corrected both for plasma volume changes
and for hemodilution. The platelet count and the plasma-free hemoglobin
level were not significantly altered by ECMO. Similarly, the prothrombin
complex, antithrombin, thrombin-antithrombin complex, factor XII, and the
urinary excretion of 2,3-dinor-thromboxane B2 were not significantly
altered. Fibrinogen and fibrin monomer increased significantly, whereas von
Willebrand factor was significantly decreased after ECMO. In summary,
24-hour heparin-free veno-right ventricular total extracorporeal lung
assistance does not affect the platelets and the coagulation system
significantly in healthy juvenile pigs.