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Stunned myocardium during extracorporeal membrane oxygenation
M E Dickson1, M A Hirthler, J Simoni
1Department of Surgery, Texas Tech University Health Sciences Center, Lubbock 79430.
American Journal of Surgery
|December 1, 1990
Summary
Oxygen-derived free radicals may not cause stunned myocardium in neonates undergoing extracorporeal membrane oxygenation (ECMO). Echocardiograms and cardiac enzyme tests in 16 neonates showed no simultaneous rise in lipid peroxides.
Area of Science:
- Cardiology
- Neonatology
- Biochemistry
Background:
- Stunned myocardium, a reversible myocardial dysfunction, is hypothesized to be mediated by oxygen-derived free radicals.
- This phenomenon has been observed in neonates during extracorporeal membrane oxygenation (ECMO).
Purpose of the Study:
- To investigate the potential role of oxygen-derived free radicals in the development of stunned myocardium in neonates undergoing ECMO.
- To correlate echocardiographic findings of myocardial stunning with biochemical markers.
Main Methods:
- Echocardiograms were performed on 16 neonates before, during, and after ECMO.
- Blood samples were analyzed for creatine phosphokinase isoenzymes (specifically the MB fraction) and lipid peroxide levels.
Main Results:
- Neonates who developed echocardiographic evidence of stunned myocardium did so shortly after initiating bypass.
- Concurrent elevations in the MB fraction of creatine phosphokinase were observed in these infants.
- Lipid peroxide levels did not show a simultaneous increase, challenging the free radical hypothesis.
Conclusions:
- The findings suggest that oxygen-derived free radicals may not be the primary cause of stunned myocardium in neonates undergoing ECMO.
- Further research is needed to elucidate the exact mechanisms underlying this condition.