Acute Immune Response in Venoarterial and Venovenous Extracorporeal Membrane Oxygenation Models of Rats

Abstract

Although experimental extracorporeal membrane oxygenation (ECMO) animal models have been reported, there are few studies on the immune response to ECMO. We developed the venoarterial (VA) and venovenous (VV) model in rats and serially investigated the changes in the distribution of immune cells. Forty rats underwent both VA and VV modes of ECMO, and blood samples were collected at 1 day before ECMO (D-1), at the end of ECMO run (D+0), and 3 days after the ECMO (D+3). Flow cytometry was used to characterize surface marker expression (CD3, CD4, CD8, CD43, CD45, CD45R, CD161, and His48) on immune cells. Granulocytes were initially activated in both ECMO types and were further reduced but not normalized until 3 days of decannulation. Monocyte and natural killer cells were decreased initially in VA mode. B lymphocytes, helper T lymphocytes, and cytotoxic T lymphocytes also significantly decreased in VA modes after ECMO, but this phenomenon was not prominent in the VV modes. Overall immune cells proportion changed after ECMO run in both modes, and the immunologic balance altered significantly in the VA than in VV mode. Our ECMO model is feasible for the hemodynamic and immunologic research, and further long-term evaluation is needed. ASAIO

Combined effects of sepsis and extracorporeal membrane oxygenation on left ventricular performance in a murine model

“…The ECMO circuit configuration employed has been described previously 16 . ECMO cannulation was done via the right jugular vein and left femoral artery.…”

“…ECMO cannulation was done via the right jugular vein and left femoral artery. A modified neonatal feeding tube was used for the drainage cannula, and a 24 G angiocatheter was used as the arterial return cannula 16 .…”

Opportunities, controversies, and challenges of extracorporeal hemoadsorption with CytoSorb during ECMO

“…FP: Well, it is common knowledge that ECMO per se triggers inflammation (Table 1). [5][6][7][8][9][10][11] This fact, plus the clinical condition by which the patient is affected, produces a "toxic milieu," which should be considered as the rationale for CytoSorb use. Literature on inflammation triggered by cardiopulmonary bypass can further be extrapolated to support the use of CytoSorb in ECMO patients.…”

“…Notwithstanding various advantages and chances of ECMO support, its use is often associated with and complicated by severe generalized hyperinflammation, which occurs due to the underlying disease as well as the ECMO circuit itself (Table1). [4][5][6][7][8][9][10][11] Hyperinflammation contributes to vasoplegia, multiple organ failure and death, but targeted interventions to limit or revert hyperinflammation have been largely unsuccessful.…”

Does adjunctive hemoadsorption with CytoSorb affect survival of COVID-19 patients on ECMO? Authors' response

“…Inclusion criteria in our trial were thoroughly defined. The rationale for the use cytokine adsorption in the CYCOV trial was not only inflammation due to coronavirus disease 2019 (COVID-19), but also additional activation of inflammatory response by the initiation of extracorporeal membrane oxygenation [ 5 , 6 ].…”