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The aim of this study was to assess alterations in neutrophil phenotype and function in pump\u2010assisted circulation in vitro.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Human blood was circulated for four hours in three circulatory flow loops with a CentriMag blood pump operated at a flow of 4.5 L\/min at three rotational speeds (2100, 2800, and 4000\u00a0rpm), against three pressure heads (75, 150, and 350\u00a0mm\u00a0Hg), respectively. Blood samples were collected hourly for analyses of neutrophil activation state (Mac\u20101, CD62L, CD162), neutrophil reactive oxygen species (ROS) production, apoptosis, and neutrophil phagocytosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Activated neutrophils indicated by both Mac\u20101 expression and decreased surface expression of CD62L and CD162 receptors increased with time in three loops. The highest level of neutrophil activation was observed in the loop with the highest rotational speed. Platelet\u2010neutrophil aggregates (PNAs) progressively increased in two loops with lower rotational speeds. PNAs peaked at one hour after circulation and decreased subsequently in the loop with the highest rotational speed. Neutrophil ROS production dramatically increased at one hour after circulation and decreased subsequently in all three loops with similar levels and trends. Apoptotic neutrophils increased with time in all three loops. Neutrophil phagocytosis capacity in three loops initially elevated at one hour after circulation and decreased subsequently. Apoptosis and altered phagocytosis were dependent on rotational speed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study revealed that the pump\u2010assisted circulation induced neutrophil activation, apoptosis, and functional impairment. The alterations were strongly associated with pump operating condition and duration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14068","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T14:29:50Z","timestamp":1631543390000},"page":"83-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neutrophil dysfunction due to continuous mechanical shear exposure in mechanically assisted circulation in vitro"],"prefix":"10.1111","volume":"46","author":[{"given":"Wenji","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiafeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakash","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0779-3405","authenticated-orcid":false,"given":"Katherin","family":"Arias","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine  Baltimore Maryland USA"},{"name":"Fischell Department of Bioengineering A. 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