{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:11:50Z","timestamp":1790784710681,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T00:00:00Z","timestamp":1619308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council Centre for Research Excellence in Advanced Cardio-respiratory Therapies Improving Organ Support","award":["APP1079421"],"award-info":[{"award-number":["APP1079421"]}]},{"name":"The Prince Charles Hospital Foundation Research Fellowships","award":["RF2019-02"],"award-info":[{"award-number":["RF2019-02"]}]},{"name":"The Prince Charles Hospital Foundation Team Grant","award":["TM2017-04"],"award-info":[{"award-number":["TM2017-04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Membranes"],"abstract":"<jats:p>In vitro hemolysis testing is commonly used to determine hemocompatibility of ExtraCorporeal Membrane Oxygenation (ECMO). However, poor reproducibility remains a challenging problem, due to several unidentified influencing factors. The present study investigated potential factors, such as flow rates, the use of anticoagulants, and gender of blood donors, which could play a role in hemolysis. Fresh human whole blood was anticoagulated with either citrate (n = 6) or heparin (n = 12; 6 female and 6 male blood donors). Blood was then circulated for 360 min at 4 L\/min or 1.5 L\/min. Regardless of flow rate conditions, hemolysis remained unchanged over time in citrated blood, but significantly increased after 240 min circulation in heparinized blood (p \u2264 0.01). The ratio of the normalized index of hemolysis (NIH) of heparinized blood to citrated blood was 11.7-fold higher at 4 L\/min and 16.5\u2013fold higher at 1.5 L\/min. The difference in hemolysis between 1.5 L\/min and 4 L\/min concurred with findings of previous literature. In addition, the ratio of NIH of male heparinized blood to female was 1.7-fold higher at 4 L\/min and 2.2-fold higher at 1.5 L\/min. Our preliminary results suggested that the choice of anticoagulant and blood donor gender could be critical factors in hemolysis studies, and should be taken into account to improve testing reliability during ECMO.<\/jats:p>","DOI":"10.3390\/membranes11050313","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T22:31:39Z","timestamp":1619389899000},"page":"313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Extracorporeal Membrane Oxygenation-Induced Hemolysis: An In Vitro Study to Appraise Causative Factors"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7983-5614","authenticated-orcid":false,"given":"Chris","family":"Chan","sequence":"first","affiliation":[{"name":"School of Engineering and Built Environment, Griffith University, Gold Coast 4222, Australia"},{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Ki","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6970-6154","authenticated-orcid":false,"given":"Meili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"School of Mechanical and Mining Engineering, University of Queensland, Brisbane 4067, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cooper","family":"Asnicar","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2458-8529","authenticated-orcid":false,"given":"Hwa Jin","family":"Cho","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Department of Pediatrics, Chonnam National University Children\u2019s Hospital and Medical School, Gwangju 61469 42, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Ainola","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7394-7121","authenticated-orcid":false,"given":"Mahe","family":"Bouquet","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-4816","authenticated-orcid":false,"given":"Silver","family":"Heinsar","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Pauls","sequence":"additional","affiliation":[{"name":"School of Engineering and Built Environment, Griffith University, Gold Coast 4222, Australia"},{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Li Bassi","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacky","family":"Suen","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Fraser","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane 4032, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane 4006, Australia"},{"name":"School of Medicine, Griffith University, Gold Coast 4222, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,25]]},"reference":[{"key":"ref_1","first-page":"E166","article-title":"Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology","volume":"7","author":"Makdisi","year":"2015","journal-title":"J. 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