1. Extracorporeal Membrane Oxygenation Blood Flow and Blood Recirculation Compromise Thermodilution-Based Measurements of Cardiac Output
- Author
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Steffen Weber-Carstens, Philipp A. Pickerodt, Jenelle Badulak, Martin Russ, Christoph Melzer-Gartzke, Elvira Steiner, Erik R. Swenson, Roland C. E. Francis, Thilo Busch, Willehad Boemke, and Mahdi Taher
- Subjects
medicine.medical_specialty ,Cardiac output ,Swine ,medicine.medical_treatment ,Thermodilution ,Biomedical Engineering ,Biophysics ,Bioengineering ,Lung injury ,Extracorporeal ,Biomaterials ,Extracorporeal Membrane Oxygenation ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Animals ,Cardiac Output ,Lung ,business.industry ,Ultrasound ,Hemodynamics ,Pulmonary artery catheter ,General Medicine ,Blood flow ,medicine.anatomical_structure ,Cardiology ,business - Abstract
The contribution of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) to systemic oxygen delivery is determined by the ratio of total extracorporeal blood flow (Q˙EC) to cardiac output (Q˙). Thermodilution-based measurements of Q˙ may be compromised by blood recirculating through the ECMO (recirculation fraction; Rf). We measured the effects of Q˙EC and Rf on classic thermodilution-based measurements of Q˙ in six anesthetized pigs. An ultrasound flow probe measured total aortic blood flow (Q˙A0) at the aortic root. Rf was quantified with the ultrasound dilution technique. Q˙EC was set to 0-125% of Q˙A0 and Q˙ was measured using a pulmonary artery catheter (PAC) in healthy and lung injured animals. PAC overestimated Q˙ (Q˙Pa) at all Q˙EC settings compared to Q˙A0. The mean bias between both methods was 2.1 L/min in healthy animals and 2.7 L/min after lung injury. The difference between Q˙Pa and Q˙A0 increased with an Q˙EC of 75-125%/Q˙A0 compared to QEC
- Published
- 2021
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