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Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
935
Experimental Venoarterial Extracorporeal Membrane Oxygenation Induces Left Ventricular Dysfunction
Petter Schiller1, Per Vikholm, Laila Hellgren
1From the Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|May 20, 2016
Summary
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can cause left ventricular (LV) dilatation and dysfunction. This study found VA-ECMO reduced LV function and increased volumes, regardless of cannulation site in pigs.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for acute cardiac failure.
- Limited literature exists on VA-ECMO's negative impacts on cardiac function, including left ventricular (LV) dilatation and stunning.
Purpose of the Study:
- To investigate the effects of experimental VA-ECMO on LV function.
- To compare LV response to VA-ECMO using peripheral versus central cannulation techniques.
Main Methods:
- Ten pigs were randomized to either peripheral or central VA-ECMO cannulation.
- Left ventricular performance was assessed using pressure-volume catheters over 5 hours of VA-ECMO.
- Measurements included LV volumes, ejection fraction, stroke work, and pressure changes.
Main Results:
- VA-ECMO led to comparable increases in LV end-diastolic and end-systolic volumes in both cannulation groups.
- Left ventricular ejection fraction, stroke work, and maximum rate of pressure change decreased over time on VA-ECMO.
- Cannulation site did not influence the observed LV response to VA-ECMO.
Conclusions:
- VA-ECMO increases LV volumes and impairs LV function in this experimental model.
- Reduced LV ejection fraction and stroke work indicate significant LV dysfunction during VA-ECMO support.
- The cannulation strategy (peripheral vs. central) did not alter these detrimental effects on LV function.
