| Quantifying recirculation in extracorporeal membrane oxygenation: a new technique validated. | |
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MedLine Citation:
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PMID: 20037890 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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RATIONALE: The efficacy of veno-venous extracorporeal membrane oxygenation is limited by the phenomenon of recirculation, which is difficult to quantify. Existing measurement techniques using readily available equipment are unsatisfactory. OBJECTIVES: 1) To compare the accuracy of measurements of recirculation made using equations comparing blood oxygen content or saturation alone at different points in an ex vivo circuit; 2) to validate a new step-change technique for quantifying recirculation in vivo. METHODS: anesthetized greyhound dogs cannulated for veno-arterial support were connected to a circuit that allowed the creation of a known level of recirculation ex vivo and blood oxygen content/saturation monitoring. In two dogs, the accuracy of measurements derived from oxygen content and oxygen saturation were compared. The potential of a new technique for measuring recirculation in vivo by comparing the oxygen content of blood sampled during oxygenator bypass to that following a step-change in circuit oxygenation was demonstrated in a veno-venous pilot study and validated in a three-dog veno-arterial study. RESULTS: Measurements made using oxygen content versus oxygen saturation showed superior correlation with true recirculation (r(2)=0.87 vs. 0.64, p<0.0001) and less proportional measurement bias (10.3% vs. 49.8%, p=0.0045). Measurements of recirculation made using a step-change in circuit oxygenation and comparing oxygen content as is required for measuring in vivo recirculation overestimated by only 18.6% (95% Cl: 3.9-33.2%) and had excellent correlation with true values (r(2)=0.89). CONCLUSIONS: 1) Measurement of recirculation using oxygen content is superior to that using oxygen saturation alone, which demonstrates significant measurement bias; 2) the novel step-change technique is a sufficiently accurate technique for the measurement of recirculation in animal models. |
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Authors:
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Steven J Lindstrom; Mark T Mennen; Franklin L Rosenfeldt; Robert F Salamonsen |
Publication Detail:
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Type: Comparative Study; Journal Article; Validation Studies |
Journal Detail:
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Title: The International journal of artificial organs Volume: 32 ISSN: 0391-3988 ISO Abbreviation: Int J Artif Organs Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-28 Completed Date: 2010-03-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802649 Medline TA: Int J Artif Organs Country: Italy |
Other Details:
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Languages: eng Pagination: 857-63 Citation Subset: IM |
Affiliation:
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Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. s.lindstrom@alfred.org.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Biological Markers / blood Dogs Extracorporeal Membrane Oxygenation / methods* Femoral Artery* Femoral Vein* Models, Animal Models, Biological* Oxygen / blood* Pilot Projects Reproducibility of Results Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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