Hemodynamic response to pumpless extracorporeal membrane oxygenation

Chapman, John H.; Adams, Merrill; Geha, Alexander S.

doi:10.1016/s0022-5223(19)36952-1

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…The setting of 10% of the CO as the minimum bypass flow was used based on the study by Brunston et al ( 23 ), who reported that a gradual rise in the systemic PaCO 2 was seen at flows of >500 ml/min (~7% of the CO) in healthy sheep. Again, when the blood flow exceeded 25% of the CO, vasoactive drugs are usually required ( 24 ). The results of the present study revealed that a maximum flow of 25% of the CO is recommended, as it does not cause any fluctuation of hemodynamic parameters and does not require vasopressor agent application.…”

Section: Discussionmentioning

confidence: 99%

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

Wang

et al. 2017

Exp Ther Med

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Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h. Improved oxygenation [partial oxygen pressure (PaO2) and oxygen saturation (SaO2) was measured by arterial blood gas analysis, and increased by 29 and 18%, respectively] and CO2 elimination (partial CO2 pressure decreased by 43.35%) were obtained after pECLA implementation. A maximum arterio-venous shunt flow of up to 25% of the foundational CO resulted in stable hemodynamics. The pECLA procedure did not elicit any further increase in the concentration of tumor necrosis factor-α, interleukin (IL)-6, IL-8 and endothelin-1 compared with that in the group subjected to oleic acid injection only. In addition, the pECLA procedure had no effect on lactate levels and urine production. In conclusion, pECLA is an efficient and promising strategy for providing a mild to moderate oxygenation and adequate decarboxylation, while avoiding excessive inflammatory cascade response and tissue hypoperfusion in an experimental ALI model.

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Section: Discussionmentioning

confidence: 99%

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

Wang

et al. 2017

Exp Ther Med

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“…CHAPMAN et al [15] investigated the hemodynamic response to pump-less membrane extracorporeal oxygenation in 11 dogs induced to respiratory insufficiency by the intravenous use of oleic acid (0.01 mL/kg). The results demonstrated that there was an improvement in the gasometry, resulting in significant alterations in the peripheral vascular resistance, systemic arterial pressure and cardiac output.…”

Section: Rev Bras Cir Cardiovasc 2003; 18(4): 359-363mentioning

confidence: 99%

Perspective of clinical application of pumpless extracorporeal lung assist (ECMO) in newborn

Gandolfi¹,

Braile²

2003

Rev Bras Cir Cardiovasc

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Extracorporeal lung assist (ECLA) has been proposed as an invasive alternative to conventional treatment when oxygenation is not possible by rigorous mechanical ventilation alone. Usually, ECLA is carried out by establishing a venovenous or venoarterial shunt consisting of a roller or centrifugal pump, a membrane oxygenator, and a heat exchanger. However, the extracorporeal membrane oxygenation (ECMO) with circulatory support lead hemolysis, coagulation disorders, inflammatory response, and specific technical complications inherent to a procedure of high risk and cost. To reduce the drawbacks of mechanical blood trauma during prolonged ECLA, the patient´s arteriovenous pressure gradient as the driving force for the blood flow through for the extracorporeal circuit can be used. In this article are analysed the main contributions of pumpless ECMO, used experimentally and in children and adults with respiratory failure, with perspective of clinical application in newborn. Descriptors: Extracorporeal membrane oxygenation. Membrane oxygenators. Oxygenators. Infant, newborn. Resumo A assistência pulmonar extracorpórea tem sido proposta como uma alternativa invasiva ao tratamento convencional, quando a oxigenação adequada torna-se impossível pelo uso de ventilação mecânica. Usualmente, a ventilação extracorpórea é realizada por meio de shunt veno-venoso ou

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“…Other arteriovenous CO2 removal (AVCO2R) studies have also been accompanied by hemodynamic instability. 15 We recently developed an AVCOaR circuit with use of a new low-resistance membrane oxygenator to provide total CO 2 removal in both healthy a6 and injured 17 sheep models of severe respiratory failure. Total CO 2 removal could be achieved with significant reductions in minute ventilation and peak inspiratory pressures.…”

mentioning

confidence: 99%

Prolonged hemodynamic stability during arteriovenous carbon dioxide removal for severe respiratory failure

Brunston¹,

Tao²,

Bidani³

et al. 1997

The Journal of Thoracic and Cardiovascular Surgery

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Hemodynamic response to pumpless extracorporeal membrane oxygenation

Cited by 7 publications

References 13 publications

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

Perspective of clinical application of pumpless extracorporeal lung assist (ECMO) in newborn

Prolonged hemodynamic stability during arteriovenous carbon dioxide removal for severe respiratory failure

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