Document Detail


Veno-right ventricular cannulation reduces recirculation in extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  22733979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Veno-venous extracorporeal membrane oxygenation has several advantages over veno-arterial support for patients with severe reversible respiratory failure. However, recirculation can limit oxygen delivery as pump flow increases. This could be ameliorated by placing the return catheter in the right ventricle instead of the central veins. We compared recirculation in veno-right ventricular support with that in conventional veno-venous support and its relationship with pump flow.
METHODS: Five greyhound dogs were sequentially cannulated percutaneously for both veno-venous and veno-right ventricular support. Recirculation was measured by comparing oxygen levels in the circuit drainage and return lines before and immediately after a sudden increase in circuit oxygenation at pump flows between 0.5 L/min and 4 L/min for both modalities.
RESULTS: Recirculation was reduced in veno-right ventricular support compared with conventional veno-venous support at 4 L/min pump flow (8.4% versus 37.9%, p=0.0076) and increased less with increases in pump flow (2.9% per 1 L/min vs. 11.1% per 1 L/min, p<0.0001).
CONCLUSIONS: Recirculation can be dramatically reduced by returning blood into the right ventricle, which improves oxygen delivery to the lungs and the systemic circulation. The design of specialized catheters may facilitate percutaneous ventricular cannulation, improve safety and further reduce recirculation.
Authors:
S J Lindstrom; M T Mennen; F L Rosenfeldt; R F Salmonsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-25
Journal Detail:
Title:  Perfusion     Volume:  27     ISSN:  1477-111X     ISO Abbreviation:  Perfusion     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-06-18     Revised Date:  2014-02-07    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  464-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Arrhythmias, Cardiac / etiology
Catheterization / instrumentation,  methods*
Disease Models, Animal
Dogs
Extracorporeal Membrane Oxygenation / instrumentation,  methods*
Hemodynamics
Oxygen / blood*
Respiration, Artificial
Vena Cava, Superior
Ventricular Function, Right
Chemical
Reg. No./Substance:
S88TT14065/Oxygen
Comments/Corrections
Comment In:
Perfusion. 2014 Jan;29(1):94-5   [PMID:  23652983 ]
Perfusion. 2013 Jul;28(4):368-9   [PMID:  23459793 ]
Perfusion. 2013 Jul;28(4):370   [PMID:  23785028 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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