The characterisation of protein and cellular binding in paediatric extracorporeal membrane oxygenation (ECMO) circuits using proteomics, immunofluorescence, and scanning electron microscopy

Extracorporeal membrane oxygenation (ECMO) has been increasingly applied to both adult and paediatric patients worldwide. However, continuous contact between blood and foreign surface of the ECMO circuit may contribute to haemostatic, inflammatory and other physiological disturbances during ECMO. Although previous studies have extensively investigated blood samples from patients on ECMO, the protein and cellular binding to the ECMO circuit has largely been overlooked as an additional factor that could contribute to differences in clinical outcomes. The detailed protocol described in this paper enables the comprehensive characterisation of protein and cellular binding in paediatric ECMO circuits, which could extend our knowledge of the pathophysiology of circuit binding and provide guidance for improved ECMO circuit design.