Journal Article PUBDB-2026-00806

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Multimodal characterization of flow-induced thrombus initiation and growth in extracorporeal membrane oxygenation

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2026
Springer Nature [London]

Scientific reports 16, 7166 () [10.1038/s41598-026-40177-3]
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Abstract: In cases of severe cardiopulmonary failure, extracorporeal membrane oxygenation (ECMO) may be temporarily used as a life-saving support for cardiac and/or lung function. Operating under non-physiological flow conditions, characterized by elevated shear rates and stagnant flow zones, there is an increased risk of inducing thrombosis, bleeding and hemolysis. Pinpointing the underlying mechanism triggering the onset of thrombus formation may aid development of device design, as well as management of anti-coagulation, benefiting patient outcome. Here we present a combined methodology enabling a multiscale understanding of thrombus development. Two thrombi collected from different ECMO circuits were analyzed by computational fluid dynamics (CFD), ultra small angle X-ray scattering (USAXS) and scanning electron microscopy (SEM). USAXS quantified the density and bulk alignment of fibrin, building the thrombus scaffold structure. SEM provided information on cellular morphology and surface fibrin structure, and CFD identified regions in the ECMO circuit with high thrombotic potential. Together, this combined approach was able to link local flow conditions and the structural growth of thrombi in ECMO circuits.

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Note: Open access funding provided by Royal Institute of Technology. The research was funded by the Swedish Re-search Council (Vetenskapsrådet) through grant no. 2019-04800. The computations were enabled by resources provided by the National Academic Infrastructure for Supercomputing in Sweden (NAISS), partially funded by the Swedish Research Council through grant agreement no. 2022-06725. The SEM measurements were partly funded by a scholarship “Collaboration and networking within Life Science” from the KTH life science platform. Stockholm Society of Extracorporeal Membrane Oxygenation (SEKMO) provided a scholarship to present part sof the work at EuroELSO 2024.

Contributing Institute(s):
  1. DOOR-User (DOOR ; HAS-User)
  2. Sustainable Materials (FS-SMA)
Research Program(s):
  1. 632 - Materials – Quantum, Complex and Functional Materials (POF4-632) (POF4-632)
  2. 6G3 - PETRA III (DESY) (POF4-6G3) (POF4-6G3)
  3. FS-Proposal: I-20221272 EC (I-20221272-EC) (I-20221272-EC)
  4. SWEDEN-DESY - SWEDEN-DESY Collaboration (2020_Join2-SWEDEN-DESY) (2020_Join2-SWEDEN-DESY)
Experiment(s):
  1. PETRA Beamline P03 (PETRA III)

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 Record created 2026-02-20, last modified 2026-03-24


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