In vitro investigation of elevated hemolysis susceptibility in neonatal blood

IntroductionHemolysis is a relevant complication and is responsible for morbidity and mortality of neonatal extracorporeal membrane oxygenation (ECMO) therapy. For novel therapies like artificial placenta, hemolysis could also lead to complications or therapy failure, especially since the targeted p...

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Main Authors: Jan Heyer, Stella Volmering, Camila Hoyos-Banchon, Sarah Koc, Lydia Jeremiah, Ulrich Steinseifer, Thorsten Orlikowsky, Sebastian V. Jansen, Johanna C. Clauser, Mark Schoberer
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1616084/full
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author Jan Heyer
Stella Volmering
Camila Hoyos-Banchon
Sarah Koc
Lydia Jeremiah
Ulrich Steinseifer
Thorsten Orlikowsky
Sebastian V. Jansen
Johanna C. Clauser
Mark Schoberer
author_facet Jan Heyer
Stella Volmering
Camila Hoyos-Banchon
Sarah Koc
Lydia Jeremiah
Ulrich Steinseifer
Thorsten Orlikowsky
Sebastian V. Jansen
Johanna C. Clauser
Mark Schoberer
author_sort Jan Heyer
collection DOAJ
description IntroductionHemolysis is a relevant complication and is responsible for morbidity and mortality of neonatal extracorporeal membrane oxygenation (ECMO) therapy. For novel therapies like artificial placenta, hemolysis could also lead to complications or therapy failure, especially since the targeted patients are born at the borderline of viability. Standardized in vitro blood testing using animal blood is commonly used to assess the hemolytic potential of newly developed systems during their design and development. However, neonatal human blood differs from animal blood. For example, neonatal blood exhibits a higher erythrocyte volume, lower overall viscosity, and greater erythrocyte elasticity. This study investigates whether the porcine blood analog, commonly used in standardized protocols, can also be used to assess hemolysis in neonatal blood.MethodsHuman neonatal blood was harvested from placentas and umbilical cords of neonates born by cesarean section. Porcine blood was obtained from a local abattoir. Both collection processes followed predefined standardized protocols. Normalized Index for hemolysis (NIH) was calculated based on determined free plasma hemoglobin.ResultThere was a significantly (p < 0.05) higher normalized index of hemolysis in the human neonatal blood group (NIH=0.165 g 100 L−1; SD=0.082) compared to the porcine group (NIH=0.101 g 100l−1; SD=0.038). In contrast, under static reference conditions, neonatal blood exhibited lower hemolysis (NIH=0.025 g 100 L−1; SD=0.018) than porcine blood (NIH=0.055 g 100l−1; SD=0.038).DiscussionIn standardized in vitro hemolysis testing, porcine blood might not serve as a suitable analog for human neonatal blood, as it significantly underestimates the hemolysis potential observed in neonatal blood.
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spelling doaj-art-c1da20fe3c4447e2a977dee9e5b4a4f82025-08-26T05:28:10ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16160841616084In vitro investigation of elevated hemolysis susceptibility in neonatal bloodJan Heyer0Stella Volmering1Camila Hoyos-Banchon2Sarah Koc3Lydia Jeremiah4Ulrich Steinseifer5Thorsten Orlikowsky6Sebastian V. Jansen7Johanna C. Clauser8Mark Schoberer9Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, GermanyDepartment of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Aachen, GermanyIntroductionHemolysis is a relevant complication and is responsible for morbidity and mortality of neonatal extracorporeal membrane oxygenation (ECMO) therapy. For novel therapies like artificial placenta, hemolysis could also lead to complications or therapy failure, especially since the targeted patients are born at the borderline of viability. Standardized in vitro blood testing using animal blood is commonly used to assess the hemolytic potential of newly developed systems during their design and development. However, neonatal human blood differs from animal blood. For example, neonatal blood exhibits a higher erythrocyte volume, lower overall viscosity, and greater erythrocyte elasticity. This study investigates whether the porcine blood analog, commonly used in standardized protocols, can also be used to assess hemolysis in neonatal blood.MethodsHuman neonatal blood was harvested from placentas and umbilical cords of neonates born by cesarean section. Porcine blood was obtained from a local abattoir. Both collection processes followed predefined standardized protocols. Normalized Index for hemolysis (NIH) was calculated based on determined free plasma hemoglobin.ResultThere was a significantly (p < 0.05) higher normalized index of hemolysis in the human neonatal blood group (NIH=0.165 g 100 L−1; SD=0.082) compared to the porcine group (NIH=0.101 g 100l−1; SD=0.038). In contrast, under static reference conditions, neonatal blood exhibited lower hemolysis (NIH=0.025 g 100 L−1; SD=0.018) than porcine blood (NIH=0.055 g 100l−1; SD=0.038).DiscussionIn standardized in vitro hemolysis testing, porcine blood might not serve as a suitable analog for human neonatal blood, as it significantly underestimates the hemolysis potential observed in neonatal blood.https://www.frontiersin.org/articles/10.3389/fped.2025.1616084/fullpreterm infantsartificial placentaneonatal blood hemolysisneonatal ECMOporcine vs. neonatal blood
spellingShingle Jan Heyer
Stella Volmering
Camila Hoyos-Banchon
Sarah Koc
Lydia Jeremiah
Ulrich Steinseifer
Thorsten Orlikowsky
Sebastian V. Jansen
Johanna C. Clauser
Mark Schoberer
In vitro investigation of elevated hemolysis susceptibility in neonatal blood
Frontiers in Pediatrics
preterm infants
artificial placenta
neonatal blood hemolysis
neonatal ECMO
porcine vs. neonatal blood
title In vitro investigation of elevated hemolysis susceptibility in neonatal blood
title_full In vitro investigation of elevated hemolysis susceptibility in neonatal blood
title_fullStr In vitro investigation of elevated hemolysis susceptibility in neonatal blood
title_full_unstemmed In vitro investigation of elevated hemolysis susceptibility in neonatal blood
title_short In vitro investigation of elevated hemolysis susceptibility in neonatal blood
title_sort in vitro investigation of elevated hemolysis susceptibility in neonatal blood
topic preterm infants
artificial placenta
neonatal blood hemolysis
neonatal ECMO
porcine vs. neonatal blood
url https://www.frontiersin.org/articles/10.3389/fped.2025.1616084/full
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