Marta Velia Antonini: Can Nitric Oxide Protect the ECMO Circuit Without Systemic Anticoagulation?
Marta Velia Antonini, Hematologist, Perfusionist ECMO and NRP Specialist and Chair of the Normothermic Regional Perfusion EuroELSO Working Group, shared on X:
“sNO in anticoagulation-contraindicated adult ECMO to provide localized antiplatelet activity at blood-circuit interface without intentionally inducing systemic anticoagulation??
10 patients with clinically significant bleeding risk 3 VV, 6 VA, 1 VP; 90% survived to decannulation
NO delivered at 20 ppm via a system connected to ML sweep-gas pathway for 2–72 days; systemic anticoagulation and antiplatelets withheld
no ML replacement for thrombosis, gas-exchange failure, pressure drop elevation, hemolysis
ML ΔP remained below 50 mm Hg in all patients
MAX MetHb 1-3.4%
no patient required sNO discontinuation
sNO was feasible in this series, and not associated with NO-attributable safety events/complications”
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