Pulsatility Protects the Endothelial Function During Extracorporeal Membrane Oxygenation

Abstract Background Pulsatile flow has been proved to protect vital organ function and microcirculation during extracorporeal membrane oxygenation (ECMO). Studies revealed that pulsatile shear stress plays a role in the microcirculatory integrity. The objective of this study was investigate how pulsatility affects wall ECMO. Methods Using i-Cor system, we compared effects pulstile or non-pulsatile flows canine ECMO model, with hemodynamic parameters peak (PWSS) calculated. Serum concentrations syndecan-1 heparan sulfate were measured at different time points Pulstile experiments also validated endothelial cells exposed magnitude pulsatility, cell viability, expressions endothelial-to-mesenchymal tranformation (EndMT) markers analyzed. Results generated more surplus energy preserved higher PWSS both negatively correlated PWSS, significantly lower levels observed group. In addition, non-pulsatility triggered EndMT, EndMT related genes up-regulated, low had lowest possibility EndMT. Conclusion maintenance by contributes beneficial on glycocalyx integrity function. Moreover, prevents cells, exhibits best protective effects. augmentation may be future direction improve clinical outcome