Prostaglandin E1 enhances safety of extracorporeal membrane oxygenation procedure

Medical Xpress / Medical University of Vienna / Am. Journal of Respiratory and Critical Care Med. ^ | July 18, 2022 | Johannes Angerer / Nina Buchtele et al

[ConservativeMind]

In case of heart and/or lung failure, an ECMO machine can be used to maintain organ function for days or even weeks. Although extracorporeal membrane oxygenation (ECMO) technology has advanced, its use can still cause fatal complications.

The team focused on prostaglandin E1 (PGE1). This is a known agent, variously used in medicine, which affects platelets and the vascular system. The researchers hypothesized that PGE1 improves the compatibility of human blood with exogenous surfaces.

Despite medical advances, the contact of blood with foreign surfaces in ECMO still poses a risk of thromboembolism. As shown in the study, those patients who received PGE1 were less likely to exhibit clotting or visible signs of bleeding. It appears promising that the agent could increase safety when ECMO is used.

The study was randomized, placebo-controlled, and double-blind.

Anticoagulation with unfractionated heparin was administered as routine therapy.

ECMO is used for extracorporeal oxygenation of the blood in patients with heart and/or lung failure. The process involves withdrawing blood from a large vein using a system of tubes, artificially enriching it with oxygen via a membrane outside the body (extracorporeal), and then pumping it back into the body through another large blood vessel near the heart. The problem of human blood being exposed to foreign surfaces remains a critical issue.

As a result of a physiological immune response, this can lead to activation of the blood coagulation system and ultimately to the formation of a blood clot that would impede the ECMO machine and/or the vessels in the patient's own body. To prevent this, patients require anticoagulation. The dosage of these must be adjusted so that, on the one hand, no clots form and, on the other hand, no bleeding occurs. Finding this balance is a major challenge in the therapeutic use of ECMO.

[ConservativeMind]

ECMO is an alternative to a mechanical ventilator, and now it appears its blood clot risk can be further minimized for patients.

[ConservativeMind]

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