Background The Emergency Bypass System (EBS, Terumo Corporation) and Permanent Life Support (PLS, MAQUET Cardiopulmonary GmbH) platforms differ in pump design and surface coating, which may influence hemocompatibility. This study compared the longitudinal hematological profiles and transfusion requirements of these systems.
Methods Adult patients who underwent extracorporeal membrane oxygenation were analyzed using 1:1 propensity score matching (74 matched pairs). The primary endpoints included hemoglobin and platelet trajectories during the first 5 days, which were analyzed using linear mixed-effects models.
Results In the matched cohort, both groups demonstrated statistically similar longitudinal declines in hemoglobin and platelet counts (p=0.525 and p=0.501, respectively). However, this apparent stability in the EBS group was achieved at a significantly higher hematological cost. Within 5 days, the EBS group required 25.5% more red blood cell transfusions (p<0.001) and 34.2% more platelet transfusions (p<0.001) than the PLS group. Multivariable analysis confirmed that the use of the PLS system was independently associated with a lower transfusion demand.
Conclusion Although laboratory trajectories were comparable during the acute phase, patients supported by EBS experienced a substantially higher transfusion burden. These findings suggest a masking effect, in which compensatory transfusions may obscure the accelerated blood cell consumption associated with EBS. Therefore, clinicians should remain vigilant regarding the potential hidden hematologic costs of EBS support, even when laboratory parameters appear stable.
Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.
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Mechanical Circulatory Support in Paraganglioma Induced Cardiogenic Shock and Intestinal Ischemia: Lessons from a Complex Case and Narrative Review Alessio Giordano, Letizia Canu, Manuela Mastronardi, Luisa Petrone, Clotilde Sparano, Mauro Marzano, Carlo Bergamini, Paolo Prosperi Journal of Clinical Medicine.2025; 14(16): 5882. CrossRef
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Clinical characteristics and outcomes of pheochromocytoma crisis: a literature review of 200 cases Y. Ando, Y. Ono, A. Sano, N. Fujita, S. Ono, Y. Tanaka Journal of Endocrinological Investigation.2022; 45(12): 2313. CrossRef
Catecholamine-induced cardiomyopathy: an endocrinologist’s perspective Aman Kumar, Joseph M Pappachan, Cornelius James Fernandez Reviews in Cardiovascular Medicine.2021;[Epub] CrossRef
Pheochromocytoma can present with various symptoms including cardiogenic shock and cardiac arrest. Particularly, in cases of cardiogenic shock of unknown origin, pheochromocytoma should be considered. A 20-year-old woman without any medical history visited our emergency department due to nausea, vomiting, headache, and chest pain. Echocardiography revealed severe left ventricular dysfunction. Mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (ECMO) were implemented owing to her unstable vital signs. For unstable vital sign and cardiogenic shock in a young woman without any previous medical history, pheochromocytoma was considered and diagnosed based on elevated levels of catecholamine derivatives in a 24-hour urine sample. Cardiac function recovered and ECMO was discontinued on the 5th day of hospitalization. She later underwent an elective adrenalectomy and no recurrence was found during the follow-up period. We reported a case of pheochromocytoma which was presented with cardiogenic shock in a young woman with no concomitant disease, and successfully treated with ECMO followed by an elective adrenalectomy.