What commonly indicates a decrease in ECMO circuit performance?

Increased transmembrane pressure is a critical indicator of a decrease in ECMO circuit performance. Transmembrane pressure refers to the pressure difference between the blood side and the air side of the membrane within the oxygenator. When the circuit performance begins to decline, it often leads to an increase in transmembrane pressure due to factors such as clot formation, membrane fouling, or a buildup of blood components on the membrane surface. This increased pressure indicates that the oxygenator may not be functioning efficiently, hindering blood flow and gas exchange, which could compromise patient oxygenation and overall circuit function.

The other choices, while important in their own contexts, do not directly indicate a decrease in ECMO circuit performance. A reduced platelet count could be related to various factors, including hemodilution or heparin usage, but it does not specifically reflect the performance of the ECMO circuit itself. Enhanced oxygenation suggests that the ECMO system is functioning well, as it indicates effective gas exchange. Increased blood temperature may have various causes but is not a direct marker of circuit performance issues. Therefore, increased transmembrane pressure stands out as the primary measure that accurately reflects decreased ECMO circuit performance.