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measured the levels of complement activation in 2 adult patients with acute respiratory distress syndrome requiring ECMO treatment, and found that early activation of the complement system may be responsible for the initiation of the inflammatory response ( It has been shown that the extracorporeal circulation line is subject to microbial colonization ( 4.2 The contact system Components of the contact system include coagulation factors XII and XI, high-molecular-weight kininogen (HMWK), and prokinetic peptide releasing enzyme (47)

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