Total EMCO support time and life span of the first ECMO system.

<p>Total EMCO support time and life span of the first ECMO system.</p

Details of acute exchange reasons for the different systems.

<p>Details of acute exchange reasons for the different systems.</p

Reasons for a system exchange.

<p>Exchange criteria from 139 ECMO patients that required a system exchange including data from five different ECMO systems (PLS, CH, HL, ECC.O5, iLA-activve, see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0198392#pone.0198392.s001" target="_blank">S1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0198392#pone.0198392.s002" target="_blank">S2</a> Tables). (A) Proportion (in %) of acute (MF, mechanical failure; AOT, acute oxygenator thrombosis; PHT, pump head thrombosis) (filled bars) and elective (GT, worsened gas transfer; CD, coagulation disorder; bleeding diathesis) exchange reasons (white bars). (B) Median (IQR) of the life span of acute and elective exchanges of the different ECMO systems. P-values compared the life span of acute and elective exchanges. The numbers within the bars represent the number of exchanges.</p

Pumphead thrombosis was documented in 8 patients.

<p>(A) Within 1 day free hemoglobin (fHb) increased significantly. After removal of the system (day 0) fHb normalized within 2 days. Data are presented as median (25/75 percentiles). Data points indicate individual patient data. Clots within pump heads of a Rotaflow (B), Rotaflex (C) and Deltastream DP3 (D).</p

Patient data and characteristics before ECMO initiation.

<p>Data are median (interquartile range).</p><p>SOFA, Sequential Organ Failure Assessment; LIS, Murray lung injury score; apH, arterial pH value; PaCO₂, partial pressure of arterial carbon dioxide; PaO₂/FiO₂, ratio of partial pressure of arterial oxygen and fraction of inspired oxygen; PIP, peak inspiratory pressure; PEEP, positive end-expiratory pressure; TV, tidal volume; BMI, body mass index; ARF, acute renal failure.</p><p>^a bacterial, viral, fungal, aspiration pneumonia and H1N1 infection.</p><p>^b other pathologies (eg. pulmonary fibrosis, near drowning, extensive bronchiectasis, pulmonary hemorrhage, tracheal laceration).</p><p>Patient data and characteristics before ECMO initiation.</p

Diagnostic group and fHb, chosen blood flow and LDH.

<p>Patients requiring ECMO therapy due to ARDS triggered by trauma (#3, n = 32) presented significantly higher fHb levels. Data are presented as median (25/75 percentiles), Error bars are 5/95 percentiles, circles are extreme values. ECMO indications: #1, primary lung failure (bacterial, viral, fungal, aspiration pneumonia, H1N1 infection); #2, sepsis with secondary lung failure; #3, trauma with ARDS; #4 other pathologies (eg. Pulmonary fibrosis, near drowning, extensive bronchiectasis, pulmonary hemorrhage, tracheal laceration).</p

Effect of pump type and cannula type on fHb, chosen blood flow and LDH during ECMO therapy.

<p>Data are presented as median (interquartile range), error bars are 5/95 percentiles, circles are extreme values.</p

Time course of fHb and LDH on vvECMO.

<p>Neither fHb nor LDH levels changed after initiation of vvECMO. Termination with successful weaning (end) did not change fHb and LDH levels. Only patients that died on the system (death) showed a significant increase in fHb and LDH values (p = 0.001, each).</p

Mortality on ECMO and hemolysis.

<p>Data are presented as median (interquartile range), error bars are 5/95 percentiles, circles are extreme values.</p

Association of technical and clinical parameters with fHb and LDH as a marker for hemolysis in vvECMO therapy.

<p>^a p-values refer to the linear mixed model based on ranks with the respective continuous parameter as independent and fHb or LDH as dependent variable. Respective p-values were mentioned in the text.</p><p>^b p-values refer to the linear mixed model based on ranks with the respective categorical parameter as independent and fHb or LDH as dependent variable (respective p-values were mentioned in the text). Pairwise comparisons (all vs. control) were only performed in case of a significant main effect (p≤0.05).</p><p>^c Single-lumen backflow (diameter, 15, 17, 19, 21 Fr), dual-lumen cannulae (Avalon 23, 27 Fr) (all Maquet), Twinport 24 Fr (Novalung).</p><p>^d bacterial, viral, fungal, aspiration pneumonia, H1N1 infection.</p><p>^e other pathologies (pulmonary fibrosis, pulmonary hypertension, extensive bronchiectasis, pulmonary bleeding, tracheal laceration).</p><p>RBC, red blood cells (one RBC contained 300 ml volume); CVVHF, continuous venovenous hemofiltration. fHb, free hemoglobin; LDH, lactate dehydrogenase; Fr, French.</p><p>Association of technical and clinical parameters with fHb and LDH as a marker for hemolysis in vvECMO therapy.</p