Exploring electrophysiology as a biomarker for human red blood cell monitoring in extracorporeal membrane oxygenation
- 1Virginia Tech - Wake Forest University School of Biomedical Engineering & Sciences
- 2Department of Engineering, Wake Forest University
Abstract
Blood monitoring in extracorporeal membrane oxygenation (ECMO) is critical to managing the precarious balance between bleeding and thrombosis in ECMO support. Conventional monitoring including plasma free hemoglobin and activated clotting time are typically limited to once-daily measurements. Considering this limitation, we investigated surface zeta (ζ) potential, as a potential real-time biomarker for monitoring red blood cells (RBCs) in ECMO. RBC ζ-potential is a negative electrical charge on the cell surface, providing repulsive force to prevent RBC aggregation in circulation. Isolated human RBCs from 7, 14, 21, and 49 days stored blood were circulated through an ECMO circuit for 12 hours. Every 2 h, ζ-potential, RBC concentration, intracellular Ca2+, and sialic acid were measured. The ζ-potential of RBCs decreased with blood circulation after only 8 h of circulation. The decrease in ζ-potential was further amplified by blood storage from just 21 days. Ca2+ and sialic acid were also shown to increase with flow and storage duration. This suggests prolonged blood storage compounds the risk of RBC aggregation. Our results demonstrate ζ-potential can detect changes in RBCs under ECMO flow conditions and clinically relevant storage times. The high temporal sensitivity of ζ-potential offers real-time detection of changes in RBC physiology to better predict cell aggregation and clotting risk, improving treatment outcomes for patients.
Related
- Single cell and bulk transcriptomics reveal metabolic reprogramming biomarker signatures during extracorporeal membrane oxygenation for cardiogenic shock
- Challenges in monitoring and titration of argatroban versus unfractionated heparin in extracorporeal membrane oxygenation.
- Mixing point thrombus during veno-arterial extracorporeal membrane oxygenation support
- Veno-arterial extracorporeal membrane oxygenation versus off-pump lung transplantation: a long-standing debate.
- Legionella Septic Cardiomyopathy Requiring Venoarterial Extracorporeal Membrane Oxygenation Followed by Presumed Complement-Mediated Thrombotic Microangiopathy: A Case Report
BibTeX
@article{eberl2026exploring,
title = {{Exploring electrophysiology as a biomarker for human red blood cell monitoring in extracorporeal membrane oxygenation}},
author = {Brandon K. Eberl and James E. Jordan and Julia N. Sullivan and Erin A. Henslee},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-63378-2},
url = {https://doi.org/10.1038/s41598-026-63378-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Exploring electrophysiology as a biomarker for human red blood cell monitoring in extracorporeal membrane oxygenation
AU - Brandon K. Eberl
AU - James E. Jordan
AU - Julia N. Sullivan
AU - Erin A. Henslee
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-63378-2
UR - https://doi.org/10.1038/s41598-026-63378-2
AB - Blood monitoring in extracorporeal membrane oxygenation (ECMO) is critical to managing the precarious balance between bleeding and thrombosis in ECMO support. Conventional monitoring including plasma free hemoglobin and activated clotting time are typically limited to once-daily measurements. Considering this limitation, we investigated surface zeta (ζ) potential, as a potential real-time biomarker for monitoring red blood cells (RBCs) in ECMO. RBC ζ-potential is a negative electrical charge on the cell surface, providing repulsive force to prevent RBC aggregation in circulation. Isolated human RBCs from 7, 14, 21, and 49 days stored blood were circulated through an ECMO circuit for 12 hours. Every 2 h, ζ-potential, RBC concentration, intracellular Ca2+, and sialic acid were measured. The ζ-potential of RBCs decreased with blood circulation after only 8 h of circulation. The decrease in ζ-potential was further amplified by blood storage from just 21 days. Ca2+ and sialic acid were also shown to increase with flow and storage duration. This suggests prolonged blood storage compounds the risk of RBC aggregation. Our results demonstrate ζ-potential can detect changes in RBCs under ECMO flow conditions and clinically relevant storage times. The high temporal sensitivity of ζ-potential offers real-time detection of changes in RBC physiology to better predict cell aggregation and clotting risk, improving treatment outcomes for patients.
SN - 2045-2322
ER -