Employing impedance aggregometry and flow cytometry, we found both impaired platelet aggregation and decreased platelet activation on day 1 of Extracorporeal Membrane Oxygenation (ECMO) support compared with healthy controls. However, platelet aggregation was not impaired, when interpreted relative to the low platelet counts.

Furthermore, levels of bound fibrinogen, on the surface of activated platelets in ECMO patients, were higher than in healthy controls. Together, these findings suggestively oppose that platelets are universally impaired during ECMO support.

No marked difference in activation from day 1 to day 3 was seen during ECMO support.

Blood samples from all 33 patients were analyzed on day 1 of ECMO support; 24 patients were still receiving ECMO and analyzed on day 3; 12 patients were analyzed on day 7.

After ECMO initiation, platelet counts decreased significantly and remained low during ECMO support. ECMO patients demonstrated significantly reduced platelet aggregation on day 1 compared with healthy controls.

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