STUDY OBJECTIVE: To investigate prospectively whether blood gas samples drawn from extracorporeal membrane oxygenation (ECMO) cannulae help to exclude at least clinically significant recirculation volumes in patients with acute respiratory failure. DESIGN: Feasibility study. SETTING: Intensive care unit at a university-affiliated hospital. PATIENTS: Ten consecutive adult patients suffering from severe respiratory failure and undergoing ECMO. INTERVENTIONS: The drawing (venous) ECMO cannula was placed into the inferior vena cava via a femoral vein, and the oxygenated blood was returned via the right subclavian vein by supraclavicular access directly into the right atrium. Blood gas samples were obtained from both cannulae. MEASUREMENTS AND MAIN RESULTS: The median arterial oxygen tension (PaO(2)) obtained from the arterial cannula was 537 mmHg (range, 366 to 625 mmHg), the median mixed venous oxygen tension (PvO(2)) drawn from the venous cannula was 42 mmHg (range, 25 to 54 mmHg), which was less than 10% of that observed in the arterial cannula, and also within the physiologic range of PvO(2). The ECMO flow necessary to maintain patients' oxygen saturation above 90% (4.1 L/min; range, 1.95 to 5.8 L/min) was significantly lower than the patients' cardiac output (CO; 6.2 L/min; range, 4.1 to 7.9 L/min; p < 0.001). CONSLUSIONS; We recommend obtaining blood gas samples-immediately after initiation of ECMO-from both cannulae. A PvO(2) within physiologic range and below 10% of PaO(2) rules out any clinically relevant recirculation volume.
STUDY OBJECTIVE: To investigate prospectively whether blood gas samples drawn from extracorporeal membrane oxygenation (ECMO) cannulae help to exclude at least clinically significant recirculation volumes in patients with acute respiratory failure. DESIGN: Feasibility study. SETTING: Intensive care unit at a university-affiliated hospital. PATIENTS: Ten consecutive adult patients suffering from severe respiratory failure and undergoing ECMO. INTERVENTIONS: The drawing (venous) ECMO cannula was placed into the inferior vena cava via a femoral vein, and the oxygenated blood was returned via the right subclavian vein by supraclavicular access directly into the right atrium. Blood gas samples were obtained from both cannulae. MEASUREMENTS AND MAIN RESULTS: The median arterial oxygen tension (PaO(2)) obtained from the arterial cannula was 537 mmHg (range, 366 to 625 mmHg), the median mixed venous oxygen tension (PvO(2)) drawn from the venous cannula was 42 mmHg (range, 25 to 54 mmHg), which was less than 10% of that observed in the arterial cannula, and also within the physiologic range of PvO(2). The ECMO flow necessary to maintain patients' oxygen saturation above 90% (4.1 L/min; range, 1.95 to 5.8 L/min) was significantly lower than the patients' cardiac output (CO; 6.2 L/min; range, 4.1 to 7.9 L/min; p < 0.001). CONSLUSIONS; We recommend obtaining blood gas samples-immediately after initiation of ECMO-from both cannulae. A PvO(2) within physiologic range and below 10% of PaO(2) rules out any clinically relevant recirculation volume.
Authors: Samuel Heuts; Maged Makhoul; Abdulrahman N Mansouri; Fabio Silvio Taccone; Amir Obeid; Mirko Belliato; Lars Mikael Broman; Maximilian Malfertheiner; Paolo Meani; Giuseppe Maria Raffa; Thijs Delnoij; Jos Maessen; Gil Bolotin; Roberto Lorusso Journal: Artif Organs Date: 2021-09-07 Impact factor: 2.663
Authors: Ayan Sen; Hannelisa E Callisen; Cory M Alwardt; Joel S Larson; Amelia A Lowell; Stacy L Libricz; Pritee Tarwade; Bhavesh M Patel; Harish Ramakrishna Journal: Ann Card Anaesth Date: 2016 Jan-Mar
Authors: Louis P Parker; Anders Svensson Marcial; Torkel B Brismar; Lars Mikael Broman; Lisa Prahl Wittberg Journal: Sci Rep Date: 2022-09-30 Impact factor: 4.996