Injection of agitated saline to detect recirculation with transthoracic echocardiography during venovenous extracorporeal oxygenation: A pilot study

Pierrakos, Charalampos; Collot, Vincent; Lieshout, Hemlata Van; Doncker, Monique De; Delcourt, Stephanie; Gottignies, Philippe; Devriendt, Jacques; Bels, David De

doi:10.1016/j.jcrc.2016.08.017

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…In general, the recirculation of ECMO was between 2% and 57%. 6,8 This result was consistent with our results. In our study, recirculation ranged from 14.64% to 40.40%.…”

Section: Discussionsupporting

confidence: 93%

“…High RF markedly decreased the efficacy of ECMO, and it may contribute to severe hypoxemia and end-organ damage. 5,6,8,9 Therefore, recirculation must be as low as possible in the clinic. Understanding the generation stages of recirculation was important to reduce RF.…”

Section: Discussionmentioning

confidence: 99%

“…As an important undesirable phenomenon of VV-ECMO, recirculation has been extensively studied by researchers. [5][6][7][8] Recirculation refers to the phenomenon that part of the oxygenated blood injected through the superior vena cava supplying (SVCS) cannulae is directly drained into the inferior vena cava draining (IVCD) cannulae without entering the systemic circulation 5 (Figure 1(b)). Lindstrom et al 6 quantified the recirculation in VV-ECMO and thought that the recirculation of oxygenated blood in the ECMO circuit reduced the efficiency of oxygen delivery to the patient.…”

Section: Introductionmentioning

confidence: 99%

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A computer model of the effect of venous-arterial-venous extracorporeal membrane oxygenation venous return of oxygenated blood on right atrial recirculation and tricuspid valve blood oxygen saturation

Kang

et al. 2022

Perfusion

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Objective Venous-arterial venous extracorporeal membrane oxygenation (V-AV ECMO), as a new clinical application of ECMO, showed great clinical application potential in the treatment of patients with combined cardiopulmonary failure. Given the complicated cannulation strategy of V-AV ECMO, its influence on the hemodynamics of the human circulatory system remained unclear. Methods In this paper, a fluid–structure interaction was used to study the effect of V-AV ECMO oxygenated blood shunt ratio on right atrial recirculation and tricuspid valve (TV) blood oxygen saturation. In this study, the right atrium, superior vena cava supplying cannulae and inferior vena cava draining cannulae model of a specific patient was constructed. Seven cases with shunt ratio of 12.50%, 18.75%, 25.00%, 31.25%, 37.50%, 43.75% and 50.00% were designed. Results The streamline diagram and velocity contour of oxygenated blood, recirculation fraction (RF), correlation of three variables (shunt ratio, RF, and oxygen saturation), and the oxygen saturation of blood at the TV were extracted for the study. Study results showed that, first, as the shunt ratio increased, the RF of the seven cases was 14.64%, 29.87%, 33.85%, 40.12%, 40.40%, 40.02%, and 38.09%. Second, with the increase of the shunt ratio, oxygen saturation of blood at the TV in seven cases was 82.1%, 82.5%, 83.3%, 83.3%, 84.0%, 84.6%, and 85.3%. Conclusions In this study, the shunt ratio had a strong correlation with the RF and oxygen saturation of blood at the TV. As the shunt ratio increased, the RF initially increased and then stabilized. However, oxygen saturation of blood at the TV would increase with the increase of the shunt ratio, but the degree of increase was small. This research provided useful information for surgeons and operators using V-AV ECMO.

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“…In general, the recirculation of ECMO was between 2% and 57%. 6,8 This result was consistent with our results. In our study, recirculation ranged from 14.64% to 40.40%.…”

Section: Discussionsupporting

confidence: 93%