RESUMO
The contribution of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) to systemic oxygen delivery is determined by the ratio of total extracorporeal blood flow () to cardiac output (). Thermodilution-based measurements of may be compromised by blood recirculating through the ECMO (recirculation fraction; Rf). We measured the effects of and Rf on classic thermodilution-based measurements of in six anesthetized pigs. An ultrasound flow probe measured total aortic blood flow () at the aortic root. Rf was quantified with the ultrasound dilution technique. was set to 0-125% of and was measured using a pulmonary artery catheter (PAC) in healthy and lung injured animals. PAC overestimated () at all settings compared to . The mean bias between both methods was 2.1 L/min in healthy animals and 2.7 L/min after lung injury. The difference between and increased with an of 75-125%/ compared to QEC <50%/. Overestimation of was highest when resulted in a high Rf. Thus, thermodilution-based measurements can overestimate cardiac output during VV ECMO. The degree of overestimation of depends on the EC/ ratio and the recirculation fraction.
Assuntos
Oxigenação por Membrana Extracorpórea , Termodiluição , Animais , Débito Cardíaco/fisiologia , Oxigenação por Membrana Extracorpórea/métodos , Hemodinâmica , Pulmão , Suínos , Termodiluição/métodosRESUMO
Interhospital transfers are an integral part of German health care system and a prerequisite to provide specialist investigation, management and best possible outcome for all patients irrespective of regional differences in medical care. In order to reduce transport associated risks to a minimum, adequate specialized transport teams and modern equipped transport vehicles are needed better and better adapted to regional and demographic changes.