Elevated hemolysis susceptibility of neonatal blood investigated in-vitro

Elevated hemolysis susceptibility of neonatal blood investigated in-vitro | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Elevated hemolysis susceptibility of neonatal blood investigated in-vitro Jan Heyer, Stella Volmering, Camila Hoyos-Banchon, Sarah Koc, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6594045/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 Aug, 2025 Read the published version in Frontiers in Pediatrics → Version 1 posted You are reading this latest preprint version Abstract Hemolysis is a relevant complication and is responsible for morbidity and mortality of neonatal ECMO therapy. For novel therapies like artificial placenta, hemolysis could also lead to complications or therapy failure, especially since the aimed patients are born at the border of viability. Standardized in-vitro blood testing using animal blood is commonly used to assess the hemolytic potential of newly developed systems during design and development. However, neonatal human blood is different compared to animal blood. Neonatal blood has for example higher erythrocyte volume, less overall viscosity and higher erythrocyte elasticity. This study investigates whether the porcine blood analogue used in the standardized protocols can also be used to assess hemolysis in neonatal blood. The human neonatal blood was harvested from the placentas and umbilical cords of neonates born by cesarean section. Porcine blood was taken from the local abattoir. Both processes followed preliminary defined standardized protocols. NIH was calculated based on determined free plasma hemoglobin. There was a significant (p<0.05) higher normalized index for 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, the static reference showed the opposite with neonatal blood hemolysis (NIH 0.025 g 100 L -1 (SD 0.018)) being lower compared to porcine blood (NIH 0.055 g 100L -1 (SD 0.038)). In standardized in-vitro hemolysis testing, porcine blood might not be a suitable analogue for human neonatal blood since a significant underestimation of hemolysis for neonatal blood was shown. Pediatrics Extremely preterm infants Artificial placenta Neonatal blood hemolysis Neonatal ECMO Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Published Journal Publication published 24 Aug, 2025 Read the published version in Frontiers in Pediatrics → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6594045","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":452052745,"identity":"8cd4d109-e4db-4000-b799-cda234551265","order_by":0,"name":"Jan Heyer","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYBACAzBZAeUxNoBIHhDBTEDLGSjvINFaGNtI0WLO3mP4uHKeXTQ/A+8z6Y87GOT5288efFzAYC2HS4tlzxljw7PbknNnNrCbSRw8w2A440xesvEMhnRjnA67kWMm2biNOXfDATa2Gwfb/jM23OAxk+ZhOJzYgEvL/TfmPxvn1Ofuh2hhsJ9/g8f8N1BLPU4tQDMZGxsO525ggGhJ3AAUYQZqScDpsDNpxZINx47nzjjMxv7jbBtD8sYzOcbSPAbphjhtOX5448eGmurc/vY2ZoPKNgbbecfPGH7mqbCWx2ULAwMHJDbRIsIAtwYGBvYH+GRHwSgYBaNgFDAwAAActFd0Qv+q7QAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0009-0002-9890-9257","institution":"Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Germany","correspondingAuthor":true,"prefix":"","firstName":"Jan","middleName":"","lastName":"Heyer","suffix":""},{"id":452053712,"identity":"3c67c43a-7748-4fb1-8218-c422644776c4","order_by":1,"name":"Stella Volmering","email":"","orcid":"","institution":"Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, University Hospital RWTH Aachen University, Germany","correspondingAuthor":false,"prefix":"","firstName":"Stella","middleName":"","lastName":"Volmering","suffix":""},{"id":452053713,"identity":"d3b9abf8-edc3-42c5-a99e-2e25ab4ee6af","order_by":2,"name":"Camila Hoyos-Banchon","email":"","orcid":"","institution":"b Department of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Germany","correspondingAuthor":false,"prefix":"","firstName":"Camila","middleName":"","lastName":"Hoyos-Banchon","suffix":""},{"id":452053714,"identity":"2019f076-6f38-4795-95e8-3be09b278718","order_by":3,"name":"Sarah Koc","email":"","orcid":"","institution":"b Department of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Germany","correspondingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"","lastName":"Koc","suffix":""},{"id":452053715,"identity":"959e1e38-ba62-4035-a5af-969976867a4b","order_by":4,"name":"Lydia Jeremiah","email":"","orcid":"","institution":"Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, University Hospital RWTH Aachen University, Germany","correspondingAuthor":false,"prefix":"","firstName":"Lydia","middleName":"","lastName":"Jeremiah","suffix":""},{"id":452053716,"identity":"293b27f6-80bb-4857-ac94-23e9a475f5bd","order_by":5,"name":"Ulrich Steinseifer","email":"","orcid":"","institution":"Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, University Hospital RWTH Aachen University, Germany","correspondingAuthor":false,"prefix":"","firstName":"Ulrich","middleName":"","lastName":"Steinseifer","suffix":""},{"id":452053717,"identity":"913ab059-44ca-4d99-ac4a-e26d50611453","order_by":6,"name":"Thorsten Orlikowsky","email":"","orcid":"","institution":"b Department of Pediatric and Adolescent Medicine, Neonatology, Medical Faculty, University Hospital RWTH Aachen, Germany","correspondingAuthor":false,"prefix":"","firstName":"Thorsten","middleName":"","lastName":"Orlikowsky","suffix":""},{"id":452053718,"identity":"0916641c-fdbf-4fce-bd4f-3dd7825de4da","order_by":7,"name":"Sebastian V. 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For novel therapies like artificial placenta, hemolysis could also lead to complications or therapy failure, especially since the aimed patients are born at the border of viability. Standardized in-vitro blood testing using animal blood is commonly used to assess the hemolytic potential of newly developed systems during design and development. However, neonatal human blood is different compared to animal blood. Neonatal blood has for example higher erythrocyte volume, less overall viscosity and higher erythrocyte elasticity. This study investigates whether the porcine blood analogue used in the standardized protocols can also be used to assess hemolysis in neonatal blood.\u003c/p\u003e\n\u003cp\u003eThe human neonatal blood was harvested from the placentas and umbilical cords of neonates born by cesarean section. Porcine blood was taken from the local abattoir. Both processes followed preliminary defined standardized protocols. NIH was calculated based on determined free plasma hemoglobin.\u003c/p\u003e\n\u003cp\u003eThere was a significant (p\u0026lt;0.05) higher normalized index for hemolysis in the human neonatal blood group (NIH 0.165 g\u0026nbsp;100\u0026nbsp;L\u003csup\u003e-1\u003c/sup\u003e (SD 0.082)) compared to the porcine group (NIH 0.101\u0026nbsp;g\u0026nbsp;100L\u003csup\u003e-1\u003c/sup\u003e (SD 0.038)). In contrast, the static reference showed the opposite with neonatal blood hemolysis (NIH 0.025 g\u0026nbsp;100\u0026nbsp;L\u003csup\u003e-1\u003c/sup\u003e (SD 0.018)) being lower compared to porcine blood (NIH 0.055\u0026nbsp;g\u0026nbsp;100L\u003csup\u003e-1\u003c/sup\u003e (SD 0.038)).\u003c/p\u003e\n\u003cp\u003eIn standardized in-vitro hemolysis testing, porcine blood might not be a suitable analogue for human neonatal blood since a significant underestimation of hemolysis for neonatal blood was shown.\u003c/p\u003e","manuscriptTitle":"Elevated hemolysis susceptibility of neonatal blood investigated in-vitro","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 11:42:29","doi":"10.21203/rs.3.rs-6594045/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"dadc1ecf-22b6-4287-af68-7046d314adc3","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":48075949,"name":"Pediatrics"}],"tags":[],"updatedAt":"2025-09-03T17:27:46+00:00","versionOfRecord":{"articleIdentity":"rs-6594045","link":"https://doi.org/10.3389/fped.2025.1616084","journal":{"identity":"frontiers-in-pediatrics","isVorOnly":true,"title":"Frontiers in Pediatrics"},"publishedOn":"2025-08-25 00:00:00","publishedOnDateReadable":"August 25th, 2025"},"versionCreatedAt":"2025-05-06 11:42:29","video":"","vorDoi":"10.3389/fped.2025.1616084","vorDoiUrl":"https://doi.org/10.3389/fped.2025.1616084","workflowStages":[]},"version":"v1","identity":"rs-6594045","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6594045","identity":"rs-6594045","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}