Filip Ježek1,2, Svitlana Strunina3, Brian E Carlson2, Jiří Hozman3. 1. Department of Pathophysiology, First Faculty of Medicine, Charles University, Prague 2, Czech Republic. 2. Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA. 3. Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic.
Abstract
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation can be vital to support patients in severe or rapidly progressing cardiogenic shock. In cases of left ventricular distension, left ventricular decompression during veno-arterial extracorporeal membrane oxygenation may be a crucial factor influencing the patient outcome. Application of a double lumen arterial cannula for a left ventricular unloading is an alternative, straightforward method for left ventricular decompression during extracorporeal membrane oxygenation in a veno-arterial configuration. OBJECTIVES: The purpose of this article is to use a mathematical model of the human adult cardiovascular system to analyze the left ventricular function of a patient in cardiogenic shock supported by veno-arterial extracorporeal membrane oxygenation with and without the application of left ventricular unloading using a novel double lumen arterial cannula. METHODS: A lumped model of cardiovascular system hydraulics has been coupled with models of non-pulsatile veno-arterial extracorporeal membrane oxygenation, a standard venous cannula, and a drainage lumen of a double lumen arterial cannula. Cardiogenic shock has been induced by decreasing left ventricular contractility to 10% of baseline normal value. RESULTS: The simulation results indicate that applying double lumen arterial cannula during veno-arterial extracorporeal membrane oxygenation is associated with reduction of left ventricular end-systolic volume, end-diastolic volume, end-systolic pressure, and end-diastolic pressure. CONCLUSIONS: A double lumen arterial cannula is a viable alternative less invasive method for left ventricular decompression during veno-arterial extracorporeal membrane oxygenation. However, to allow for satisfactory extracorporeal membrane oxygenation flow, the cannula design has to be revisited.
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation can be vital to support patients in severe or rapidly progressing cardiogenic shock. In cases of left ventricular distension, left ventricular decompression during veno-arterial extracorporeal membrane oxygenation may be a crucial factor influencing the patient outcome. Application of a double lumen arterial cannula for a left ventricular unloading is an alternative, straightforward method for left ventricular decompression during extracorporeal membrane oxygenation in a veno-arterial configuration. OBJECTIVES: The purpose of this article is to use a mathematical model of the human adult cardiovascular system to analyze the left ventricular function of a patient in cardiogenic shock supported by veno-arterial extracorporeal membrane oxygenation with and without the application of left ventricular unloading using a novel double lumen arterial cannula. METHODS: A lumped model of cardiovascular system hydraulics has been coupled with models of non-pulsatile veno-arterial extracorporeal membrane oxygenation, a standard venous cannula, and a drainage lumen of a double lumen arterial cannula. Cardiogenic shock has been induced by decreasing left ventricular contractility to 10% of baseline normal value. RESULTS: The simulation results indicate that applying double lumen arterial cannula during veno-arterial extracorporeal membrane oxygenation is associated with reduction of left ventricular end-systolic volume, end-diastolic volume, end-systolic pressure, and end-diastolic pressure. CONCLUSIONS: A double lumen arterial cannula is a viable alternative less invasive method for left ventricular decompression during veno-arterial extracorporeal membrane oxygenation. However, to allow for satisfactory extracorporeal membrane oxygenation flow, the cannula design has to be revisited.
Authors: R Fumagalli; M Bombino; M Borelli; F Rossi; V Colombo; G Osculati; P Ferrazzi; A Pesenti; L Gattinoni Journal: Int J Artif Organs Date: 2004-05 Impact factor: 1.595
Authors: Shigang Wang; Brian J Chin; Frank Gentile; Allen R Kunselman; David Palanzo; Akif Ündar Journal: Artif Organs Date: 2015-07-07 Impact factor: 3.094
Authors: Paolo Meani; Sandro Gelsomino; Eshan Natour; Daniel M Johnson; Hans-Peter Brunner La Rocca; Federico Pappalardo; Elham Bidar; Maged Makhoul; Giuseppe Raffa; Samuel Heuts; Pieter Lozekoot; Suzanne Kats; Niels Sluijpers; Rick Schreurs; Thijs Delnoij; Alice Montalti; Jan Willem Sels; Marcel van de Poll; Paul Roekaerts; Thomas Poels; Eric Korver; Zaheer Babar; Jos Maessen; Roberto Lorusso Journal: Eur J Heart Fail Date: 2017-05 Impact factor: 15.534
Authors: J Merrer; B De Jonghe; F Golliot; J Y Lefrant; B Raffy; E Barre; J P Rigaud; D Casciani; B Misset; C Bosquet; H Outin; C Brun-Buisson; G Nitenberg Journal: JAMA Date: 2001-08-08 Impact factor: 56.272
Authors: Tae Hee Hong; Joung Hun Byun; Byung Ha Yoo; Sang Won Hwang; Han Yong Kim; Jae Hong Park Journal: Korean J Thorac Cardiovasc Surg Date: 2015-06-05
Authors: Petr Ostadal; Mikulas Mlcek; Andreas Kruger; Pavel Hala; Stanislav Lacko; Martin Mates; Dagmar Vondrakova; Tomas Svoboda; Matej Hrachovina; Marek Janotka; Hana Psotova; Svitlana Strunina; Otomar Kittnar; Petr Neuzil Journal: J Transl Med Date: 2015-08-15 Impact factor: 5.531