Document Detail

Plasma fatty acid levels in children during extracorporeal membrane oxygenation support--a pilot study.
MedLine Citation:
PMID:  24649572     Owner:  NLM     Status:  In-Process    
Plasma fatty acids levels are markedly elevated in patients with myocardial ischemic-reperfusion injury including those after cardiopulmonary bypass (CPB). High levels of fatty acids have detrimental effects on myocardial function. Extracorporeal membrane oxygenation (ECMO) is like CPB, but much longer, to provide a life-saving support for patients with cardiac arrest. We measured plasma fatty acid levels in children during ECMO support. Five children (aged .3-36 months, median 20 months) receiving venoarterial ECMO support after cardiac arrest in 2010 and 2011 were enrolled. The study was initiated at 32-56 hours after the start of ECMO support as a result of the complicated clinical scenario. Fatty acids were measured at 8-hour intervals for 1-3 days. The dosage of inotropes and vasoactive agents was recorded concurrently. The duration of ECMO ranged from 70 to 240 hours (median 177 hours). Four patients were successfully weaned off ECMO support. One died after termination of ECMO. Levels of fatty acids were elevated compared with the normal values. Overall, fatty acid levels continuously decreased over time (p < .0001), the mean being 1.03 +/- .33 mmol/L in 30-50 hours, 1.01 +/- .57 in 50-70 hours, .81 +/- .32 in 70-90 hours, and .63 +/- .23 hours. No correlation was found between fatty acid levels and other clinical variables, including age, dosage of inotropes and vasoactive agents, or ECMO duration. Plasma fatty acids levels are elevated in children during ECMO support and continuously decrease over time. Fatty acid levels may be markedly higher in the immediate hours after the initiation of ECMO. Data from more patients are needed to understand the profiles of fatty acids and the correlations with clinical variables. Metabolic manipulations to decrease fatty acids might improve myocardial recovery in patients undergoing ECMO support.
Liyan Zhang; Xiaoyang Yu; Andriy Cheypesh; Ivan M Rebeyka; Don Granoski; Gary D Lopaschuk; Jia Li
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of extra-corporeal technology     Volume:  45     ISSN:  0022-1058     ISO Abbreviation:  J Extra Corpor Technol     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2014-03-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267637     Medline TA:  J Extra Corpor Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-7     Citation Subset:  T    
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