Bachmann, Kaspar Felix; Vasireddy, Rakesh; Heinisch, Paul Philipp; Jenni, Hansjörg; Vogt, Andreas; Berger, David (2021). Estimating cardiac output based on gas exchange during venoarterial extracorporeal membrane oxygenation in a simulation study using paediatric oxygenators. Scientific reports, 11(1), p. 11528. Springer Nature 10.1038/s4159802190747w

Text
2021__Bachmann__Scientific_Reports__PMID__34075067.pdf  Published Version Available under License Creative Commons: Attribution (CCBY). Download (5MB)  Preview 
Venoarterial extracorporeal membrane oxygenation (VAECMO) therapy is a rescue strategy for severe cardiopulmonary failure. The estimation of cardiac output during VAECMO is challenging. A lung circuit ([Formula: see text]Lung) and an ECMO circuit ([Formula: see text]ECMO) with oxygenators for CO2 removal ([Formula: see text]CO2) and O2 uptake ([Formula: see text]O2) simulated the setting of VAECMO with varying ventilation/perfusion ([Formula: see text]/[Formula: see text]) ratios and shunt. A metabolic chamber with a CO2/N2 blend simulated [Formula: see text]CO2 and [Formula: see text]O2. [Formula: see text] Lung was estimated with a modified Fick principle: [Formula: see text]Lung = [Formula: see text]ECMO × ([Formula: see text] CO2 or [Formula: see text]O2Lung)/([Formula: see text]CO2 or [Formula: see text]O2ECMO). A normalization procedure corrected [Formula: see text]CO2 values for a [Formula: see text]/[Formula: see text] of 1. Method agreement was evaluated by BlandAltman analysis. Calculated [Formula: see text]Lung using gaseous [Formula: see text]CO2 and [Formula: see text]O2 correlated well with measured [Formula: see text]Lung with a bias of 103 ml/min [ 268 to 185] ml/min; Limits of Agreement:  306 ml/min [ 241 to  877 ml/min] to 512 ml/min [447 to 610 ml/min], r2 0.85 [0.790.88]). Blood measurements of [Formula: see text]CO2 showed an increased bias ( 260 ml/min [ 1503 to 982] ml/min), clinically not applicable. Shunt and [Formula: see text]/[Formula: see text] mismatch decreased the agreement of methods significantly. This invitro simulation shows that [Formula: see text]CO2 and [Formula: see text]O2 in steadystate conditions allow for clinically applicable calculations of [Formula: see text]Lung during VAECMO therapy.
Item Type: 
Journal Article (Original Article) 

Division/Institute: 
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery 
UniBE Contributor: 
Bachmann, Kaspar; Vasireddy, Radhakrishna Rakesh; Heinisch, Paul Philipp; Jenni, Hansjoerg; Vogt, Andreas and Berger, David 
Subjects: 
600 Technology > 610 Medicine & health 
ISSN: 
20452322 
Publisher: 
Springer Nature 
Language: 
English 
Submitter: 
Jsabelle Arni 
Date Deposited: 
21 Jun 2021 14:42 
Last Modified: 
27 Jun 2021 03:07 
Publisher DOI: 
10.1038/s4159802190747w 
PubMed ID: 
34075067 
BORIS DOI: 
10.48350/156679 
URI: 
https://boris.unibe.ch/id/eprint/156679 