Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model

Abstract Background Oxygenator thrombosis is a potentially life-threatening complication during venovenous extracorporeal membrane oxygenation (VV ECMO). It can cause blood flow obstruction, impaired gas exchange, hematologic abnormalities, or sudden ECMO flow cessation. Early detection and timely c...

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Main Authors: Lars Prag Antonsen, Svein Aslak Landsverk, Per Steinar Halvorsen, Amrit Thiara, Didrik Lilja, Naimahmed Nesaragi, Andreas Espinoza
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:Intensive Care Medicine Experimental
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Online Access:https://doi.org/10.1186/s40635-025-00763-7
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author Lars Prag Antonsen
Svein Aslak Landsverk
Per Steinar Halvorsen
Amrit Thiara
Didrik Lilja
Naimahmed Nesaragi
Andreas Espinoza
author_facet Lars Prag Antonsen
Svein Aslak Landsverk
Per Steinar Halvorsen
Amrit Thiara
Didrik Lilja
Naimahmed Nesaragi
Andreas Espinoza
author_sort Lars Prag Antonsen
collection DOAJ
description Abstract Background Oxygenator thrombosis is a potentially life-threatening complication during venovenous extracorporeal membrane oxygenation (VV ECMO). It can cause blood flow obstruction, impaired gas exchange, hematologic abnormalities, or sudden ECMO flow cessation. Early detection and timely circuit exchange is critical yet challenging. Acute clot formation necessitates immediate circuit replacement, while premature replacement risks unnecessary procedural harm and increased costs. No reliable method exists to detect early oxygenator thrombosis. Strategies include visual inspection, monitoring the pressure difference across the oxygenator (ΔP oxy), gas exchange evaluation, and blood tests. In the present animal study, we aimed to evaluate the feasibility of accelerometer-based vibration analysis as a real-time and non-invasive method for detecting oxygenator thrombosis during VV ECMO. We hypothesized that accelerometer signals would change concurrently with or precede increases in ΔP oxy. Methods The study was performed on anesthetized and mechanically ventilated pigs (n = 7) on VV ECMO. Hemodynamic parameters, ECMO circuit pressures, and signals from an accelerometer attached to the ECMO oxygenator were continuously recorded at different pump speeds, and after anticoagulation reversal to promote thrombosis within the ECMO oxygenator. Results The primary finding of this study was a significant increase in the accelerometer signal's Root Mean Squared (RMSoxy) 15 min after anticoagulation reversal, with no rpm adjustment and without corresponding changes in ΔP oxy. Variations in RMSoxy associated with high ECMO pump speed and circuit flow were discernible from those observed following anticoagulation reversal. Conclusion The present animal study demonstrates the feasibility of accelerometer-based vibration analysis as a real-time and non-invasive method for detecting vibrations associated with reversal of anticoagulation and potential oxygenator thrombosis during VV ECMO.
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spelling doaj-art-b2d270f30a414c7ca63a6e6dc2f6f65f2025-08-20T03:25:15ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2025-06-0113111010.1186/s40635-025-00763-7Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine modelLars Prag Antonsen0Svein Aslak Landsverk1Per Steinar Halvorsen2Amrit Thiara3Didrik Lilja4Naimahmed Nesaragi5Andreas Espinoza6Department of Anesthesia and Intensive Care, Rikshospitalet, Oslo University HospitalDepartment of Anesthesia and Intensive Care, Ullevaal Hospital, Oslo University HospitalDepartment of Anesthesia and Intensive Care, Rikshospitalet, Oslo University HospitalDepartment of Cardiothoracic Surgery, Rikshospitalet, Oslo University HospitalThe Intervention Centre, Oslo University HospitalThe Intervention Centre, Oslo University HospitalDepartment of Anesthesia and Intensive Care, Rikshospitalet, Oslo University HospitalAbstract Background Oxygenator thrombosis is a potentially life-threatening complication during venovenous extracorporeal membrane oxygenation (VV ECMO). It can cause blood flow obstruction, impaired gas exchange, hematologic abnormalities, or sudden ECMO flow cessation. Early detection and timely circuit exchange is critical yet challenging. Acute clot formation necessitates immediate circuit replacement, while premature replacement risks unnecessary procedural harm and increased costs. No reliable method exists to detect early oxygenator thrombosis. Strategies include visual inspection, monitoring the pressure difference across the oxygenator (ΔP oxy), gas exchange evaluation, and blood tests. In the present animal study, we aimed to evaluate the feasibility of accelerometer-based vibration analysis as a real-time and non-invasive method for detecting oxygenator thrombosis during VV ECMO. We hypothesized that accelerometer signals would change concurrently with or precede increases in ΔP oxy. Methods The study was performed on anesthetized and mechanically ventilated pigs (n = 7) on VV ECMO. Hemodynamic parameters, ECMO circuit pressures, and signals from an accelerometer attached to the ECMO oxygenator were continuously recorded at different pump speeds, and after anticoagulation reversal to promote thrombosis within the ECMO oxygenator. Results The primary finding of this study was a significant increase in the accelerometer signal's Root Mean Squared (RMSoxy) 15 min after anticoagulation reversal, with no rpm adjustment and without corresponding changes in ΔP oxy. Variations in RMSoxy associated with high ECMO pump speed and circuit flow were discernible from those observed following anticoagulation reversal. Conclusion The present animal study demonstrates the feasibility of accelerometer-based vibration analysis as a real-time and non-invasive method for detecting vibrations associated with reversal of anticoagulation and potential oxygenator thrombosis during VV ECMO.https://doi.org/10.1186/s40635-025-00763-7VV ECMOOxygenator thrombosisAccelerometer-based vibration analysis
spellingShingle Lars Prag Antonsen
Svein Aslak Landsverk
Per Steinar Halvorsen
Amrit Thiara
Didrik Lilja
Naimahmed Nesaragi
Andreas Espinoza
Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
Intensive Care Medicine Experimental
VV ECMO
Oxygenator thrombosis
Accelerometer-based vibration analysis
title Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
title_full Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
title_fullStr Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
title_full_unstemmed Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
title_short Accelerometer-based vibration analysis and oxygenator thrombosis in venovenous ECMO: an experimental porcine model
title_sort accelerometer based vibration analysis and oxygenator thrombosis in venovenous ecmo an experimental porcine model
topic VV ECMO
Oxygenator thrombosis
Accelerometer-based vibration analysis
url https://doi.org/10.1186/s40635-025-00763-7
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