Structural recirculation and refractory hypoxemia under femoro‐jugular veno‐venous extracorporeal membrane oxygenation

Autor:	Pauline Deras, Thomas Laumon, Geoffrey Dagod, Xavier Capdevila, Jonathan Charbit, Orianne Martinez, Elie Courvalin
Rok vydání:	2021
Předmět:	medicine.medical_specialty Cardiac output Vena Cava Superior Materials science medicine.medical_treatment Biomedical Engineering Medicine (miscellaneous) Bioengineering Context (language use) Extracorporeal Hypoxemia Biomaterials Extracorporeal Membrane Oxygenation Internal medicine medicine Extracorporeal membrane oxygenation Humans Hypoxia Respiratory Distress Syndrome Models Statistical General Medicine Femoral Vein Cardiology Pulmonary shunt Arterial blood Jugular Veins medicine.symptom Shunt (electrical)
Zdroj:	Artificial Organs. 45:893-902
ISSN:	1525-1594 0160-564X
Popis:	The performance of each veno-venous extracorporeal membrane oxygenation (vv-ECMO) configuration is determined by the anatomic context and cannula position. A mathematical model was built considering bicaval specificities to simulate femoro-jugular configuration. The main parameters to define were cardiac output (QC ), blood flow in the superior vena cava (QSVC ), extracorporeal pump flow (QEC ), and pulmonary shunt (kS-PULM ). The obtained variables were extracorporeal flow ratio in the superior vena cava (EFRSVC = QEC /[QEC + QSVC ]), recirculation coefficient (R), effective extracorporeal pump flow (Qeff-EC = [1 - R] × QEC ), Qeff-EC /QC ratio, and arterial blood oxygen saturation (SaO2 ). EFRSVC increased logarithmically when QEC increased. High QC or high QSVC /QC decreased EFRSVC (range, 68%-85% for QEC of 5 L/min). R also increased following a logarithmic shape when QEC increased. The R rise was earlier and higher for low QC and high QSVC /QC (range, 12%-49% for QEC of 5 L/min). The Qeff-EC /QC ratio (between 0 and 1) was equal to EFRSVC for moderate and high QEC . The Qeff-EC /QC ratio presented the same logarithmic profile when QEC increased, reaching a plateau (range, 0.67-0.91 for QEC /QC = 1; range, 0.75-0.94 for QEC /QC = 1.5). The Qeff-EC /QC ratio was linearly associated with SaO2 for a given pulmonary shunt. SaO2
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bfda0918ed4ae2ce3498304e6797858b https://doi.org/10.1111/aor.13916 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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