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Blood flow/pump rotation ratio as an artificial lung performance monitoring tool during extracorporeal respiratory support using centrifugal pumps

OBJECTIVE: To analyze the correlations of the blood flow/pump rotation ratio and the transmembrane pressure, CO(2) and O(2) transfer during the extracorporeal respiratory support. METHODS: Five animals were instrumented and submitted to extracorporeal membrane oxygenation in a five-step protocol, in...

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Detalles Bibliográficos
Autores principales: Park, Marcelo, Mendes, Pedro Vitale, Hirota, Adriana Sayuri, dos Santos, Edzangela Vasconcelos, Costa, Eduardo Leite Vieira, Azevedo, Luciano Cesar Pontes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Brasileira de Medicina intensiva 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489787/
https://www.ncbi.nlm.nih.gov/pubmed/26340159
http://dx.doi.org/10.5935/0103-507X.20150030
Descripción
Sumario:OBJECTIVE: To analyze the correlations of the blood flow/pump rotation ratio and the transmembrane pressure, CO(2) and O(2) transfer during the extracorporeal respiratory support. METHODS: Five animals were instrumented and submitted to extracorporeal membrane oxygenation in a five-step protocol, including abdominal sepsis and lung injury. RESULTS: This study showed that blood flow/pump rotations ratio variations are dependent on extracorporeal membrane oxygenation blood flow in a positive logarithmic fashion. Blood flow/pump rotation ratio variations are negatively associated with transmembrane pressure (R(2) = 0.5 for blood flow = 1500mL/minute and R(2) = 0.4 for blood flow = 3500mL/minute, both with p < 0.001) and positively associated with CO(2) transfer variations (R(2) = 0.2 for sweep gas flow ≤ 6L/minute, p < 0.001, and R(2) = 0.1 for sweep gas flow > 6L/minute, p = 0.006), and the blood flow/pump rotation ratio is not associated with O(2) transfer variations (R(2) = 0.01 for blood flow = 1500mL/minute, p = 0.19, and R(2) = - 0.01 for blood flow = 3500 mL/minute, p = 0.46). CONCLUSION: Blood flow/pump rotation ratio variation is negatively associated with transmembrane pressure and positively associated with CO(2) transfer in this animal model. According to the clinical situation, a decrease in the blood flow/pump rotation ratio can indicate artificial lung dysfunction without the occurrence of hypoxemia.