Factors XI and XII in extracorporeal membrane oxygenation: longitudinal profile in children.

extracorporeal membrane oxygenation factor XI factor XII infant newborn

Journal

Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 06 07 2023
revised: 30 08 2023
accepted: 21 09 2023
medline: 9 1 2024
pubmed: 9 1 2024
entrez: 9 1 2024
Statut: epublish

Résumé

Extracorporeal membrane oxygenation (ECMO) is used in children with cardiopulmonary failure. While the majority of ECMO centers use unfractionated heparin, other anticoagulants, including factor XI and factor XII inhibitors are emerging, which may prove suitable for ECMO patients. However, before these anticoagulants can be applied in these patients, baseline data of FXI and FXII changes need to be acquired. This study aimed to describe the longitudinal profile of FXI and FXII antigenic levels and function before, during, and after ECMO in children. This is a prospective observational study in neonatal and pediatric patients with ECMO (<18 years). All patients with venoarterial ECMO and with sufficient plasma volume collected before ECMO, on day 1 and day 3, and 24 hours postdecannulation were included. Antigenic levels and functional activity of FXI and FXII were determined in these samples. Longitudinal profiles of these values were created using a linear mixed model. Sixteen patients were included in this study. Mean FXI and FXII antigenic levels (U/mL) changed from 7.9 and 53.2 before ECMO to 6.0 and 34.5 on day 3 and they recovered to 8.8 and 39.4, respectively, after stopping ECMO. Function (%) of FXI and FXII decreased from 59.1 and 59.0 to 49.0 and 50.7 on day 3 and recovered to 66.0 and 54.4, respectively. This study provides the first insights into changes of the contact pathway in children undergoing ECMO. FXI and FXII antigen and function change during ECMO. Results from this study can be used as starting point for future contact pathway anticoagulant studies in pediatric patients with ECMO.

Sections du résumé

Background UNASSIGNED
Extracorporeal membrane oxygenation (ECMO) is used in children with cardiopulmonary failure. While the majority of ECMO centers use unfractionated heparin, other anticoagulants, including factor XI and factor XII inhibitors are emerging, which may prove suitable for ECMO patients. However, before these anticoagulants can be applied in these patients, baseline data of FXI and FXII changes need to be acquired.
Objectives UNASSIGNED
This study aimed to describe the longitudinal profile of FXI and FXII antigenic levels and function before, during, and after ECMO in children.
Methods UNASSIGNED
This is a prospective observational study in neonatal and pediatric patients with ECMO (<18 years). All patients with venoarterial ECMO and with sufficient plasma volume collected before ECMO, on day 1 and day 3, and 24 hours postdecannulation were included. Antigenic levels and functional activity of FXI and FXII were determined in these samples. Longitudinal profiles of these values were created using a linear mixed model.
Results UNASSIGNED
Sixteen patients were included in this study. Mean FXI and FXII antigenic levels (U/mL) changed from 7.9 and 53.2 before ECMO to 6.0 and 34.5 on day 3 and they recovered to 8.8 and 39.4, respectively, after stopping ECMO. Function (%) of FXI and FXII decreased from 59.1 and 59.0 to 49.0 and 50.7 on day 3 and recovered to 66.0 and 54.4, respectively.
Conclusion UNASSIGNED
This study provides the first insights into changes of the contact pathway in children undergoing ECMO. FXI and FXII antigen and function change during ECMO. Results from this study can be used as starting point for future contact pathway anticoagulant studies in pediatric patients with ECMO.

Identifiants

DOI: 10.1016/j.rpth.2023.102252 PMID: 38193071 PMC: PMC10772870
pubmed: 38193071
doi: 10.1016/j.rpth.2023.102252
pii: S2475-0379(23)05677-7
pmc: PMC10772870
doi:

Types de publication

Journal Article

Langues

eng

Pagination

102252

Informations de copyright

© 2023 The Authors.

Auteurs

Joppe Drop (J)

Department of Paediatrics, Division of Paediatric Hematology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, South Holland, The Netherlands.
Department of Paediatrics, Division of Paediatric Intensive Care and Paediatric Surgery, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, South Holland, The Netherlands.
Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Natasha Letunica (N)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Suelyn Van Den Helm (S)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.

C Heleen van Ommen (C)

Department of Paediatrics, Division of Paediatric Hematology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, South Holland, The Netherlands.

Enno Wildschut (E)

Department of Paediatrics, Division of Paediatric Intensive Care and Paediatric Surgery, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, South Holland, The Netherlands.

Matthijs de Hoog (M)

Department of Paediatrics, Division of Paediatric Intensive Care and Paediatric Surgery, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, South Holland, The Netherlands.

Joost van Rosmalen (J)

Department of Biostatistics, Erasmus University Medical Center, Rotterdam, South Holland, The Netherlands.
Department of Epidemiology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, South Holland, The Netherlands.

Rebecca Barton (R)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Clinical Haematology, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Hui Ping Yaw (HP)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Fiona Newall (F)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Clinical Haematology, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Stephen B Horton (SB)

Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Roberto Chiletti (R)

Department of Intensive Care, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Paediatric Intensive Care Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.

Amy Johansen (A)

Department of Intensive Care, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Paediatric Intensive Care Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Derek Best (D)

Department of Intensive Care, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Paediatric Intensive Care Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Joanne McKittrick (J)

Department of Intensive Care, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Warwick Butt (W)

Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Intensive Care, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Paediatric Intensive Care Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.

Yves d'Udekem (Y)

Department of Cardiac Surgery, Children's National Heart Institute, Washington DC, USA.

Graeme MacLaren (G)

Cardiothoracic Intensive Care Unit, National University Health System, Singapore.

Matthew D Linden (MD)

School of Biomedical Sciences, The University of Western Australia, Perth, Western Australia, Australia.

Vera Ignjatovic (V)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Johns Hopkins All Children's Institute for Clinical and Translational Research, St Petersburg, Florida, USA.
Department of Paediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

Chantal Attard (C)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.

Paul Monagle (P)

Haematology Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Clinical Haematology, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.

Classifications MeSH