Biomaterial Database

Extracorporeal Membrane Oxygenation Blood Flow and Blood Recirculation Compromise Thermodilution-Based Measurements of Cardiac Output. 2022

Martin Russ, and Elvira Steiner, and Willehad Boemke, and Thilo Busch, and Christoph Melzer-Gartzke, and Mahdi Taher, and Jenelle Badulak, and Steffen Weber-Carstens, and Erik R Swenson, and Roland C E Francis, and Philipp A Pickerodt

From the Department of Anesthesiology and Intensive Care Medicine (CCM, CVK); Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

The contribution of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) to systemic oxygen delivery is determined by the ratio of total extracorporeal blood flow () to cardiac output (). Thermodilution-based measurements of may be compromised by blood recirculating through the ECMO (recirculation fraction; Rf). We measured the effects of and Rf on classic thermodilution-based measurements of in six anesthetized pigs. An ultrasound flow probe measured total aortic blood flow () at the aortic root. Rf was quantified with the ultrasound dilution technique. was set to 0-125% of and was measured using a pulmonary artery catheter (PAC) in healthy and lung injured animals. PAC overestimated () at all settings compared to . 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 and increased with an of 75-125%/ compared to QEC <50%/. Overestimation of was highest when resulted in a high Rf. Thus, thermodilution-based measurements can overestimate cardiac output during VV ECMO. The degree of overestimation of depends on the EC/ ratio and the recirculation fraction.

UI	MeSH Term	Description	Entries
D008168	Lung	Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.	Lungs
D002302	Cardiac Output	The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).	Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D006439	Hemodynamics	The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.	Hemodynamic
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D013552	Swine	Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).	Phacochoerus,Pigs,Suidae,Warthogs,Wart Hogs,Hog, Wart,Hogs, Wart,Wart Hog
D013815	Thermodilution	Measurement of blood flow based on induction at one point of the circulation of a known change in the intravascular heat content of flowing blood and detection of the resultant change in temperature at a point downstream.	Thermodilutions
D015199	Extracorporeal Membrane Oxygenation	Application of a life support system that circulates the blood through an oxygenating system, which may consist of a pump, a membrane oxygenator, and a heat exchanger. Examples of its use are to assist victims of SMOKE INHALATION INJURY; RESPIRATORY FAILURE; and CARDIAC FAILURE.	ECMO Extracorporeal Membrane Oxygenation,Oxygenation, Extracorporeal Membrane,Venoarterial ECMO,Venoarterial Extracorporeal Membrane Oxygenation,Venovenous ECMO,Venovenous Extracorporeal Membrane Oxygenation,ECLS Treatment,ECMO Treatment,Extracorporeal Life Support,ECLS Treatments,ECMO Treatments,ECMO, Venoarterial,ECMO, Venovenous,Extracorporeal Life Supports,Extracorporeal Membrane Oxygenations,Life Support, Extracorporeal,Membrane Oxygenation, Extracorporeal,Treatment, ECLS,Treatment, ECMO,Venoarterial ECMOs,Venovenous ECMOs