Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults

被引:6
作者
Badulak, Jenelle [1 ,2 ,3 ]
Abrams, Darryl [4 ]
Luks, Andrew M. [2 ]
Zakhary, Bishoy [5 ]
Conrad, Steven A. [6 ,7 ,8 ,9 ]
Bartlett, Robert [10 ]
MacLaren, Graeme [11 ]
Vercaemst, Leen [12 ]
Lorusso, Roberto [13 ]
Broman, Lars Mikael [14 ,15 ]
Agerstrand, Cara [4 ]
Price, Susanna [16 ,17 ]
Combes, Alain [18 ]
Peek, Giles [19 ]
Fan, Eddy [20 ]
Shekar, Kiran [21 ]
Fraser, John [21 ]
Brodie, Daniel [22 ]
机构
[1] Univ Washington, Dept Emergency Med, Seattle, WA 98109 USA
[2] Univ Washington, Div Pulm Crit Care & Sleep Med, Seattle, WA USA
[3] Univ Washington, Div Cardiothorac Surg, Seattle, WA USA
[4] Columbia Univ, Coll Physicians & Surg, Div Pulm Allergy & Crit Care Med, New York, NY USA
[5] Oregon Hlth & Sci Univ, Div Pulm & Crit Care Med, Portland, OR USA
[6] Louisiana State Univ Hlth Sci Ctr Shreveport, Dept Med, Shreveport, LA USA
[7] Louisiana State Univ Hlth Sci Ctr Shreveport, Dept Emergency Med, Shreveport, LA USA
[8] Louisiana State Univ Hlth Sci Ctr Shreveport, Dept Pediat, Shreveport, LA USA
[9] Louisiana State Univ Hlth Sci Ctr Shreveport, Dept Surg, Shreveport, LA USA
[10] Univ Michigan, Dept Surg, Ann Arbor, MI USA
[11] Natl Univ Singapore Hosp, Cardiothorac ICU, Singapore, Singapore
[12] Univ Hosp Gasthuisberg, Louvain, Belgium
[13] Maastricht Univ Med Ctr, Heart & Vasc Ctr, Dept Cardiothorac Surg, Maastricht, Netherlands
[14] Karolinska Univ Hosp, ECMO Ctr Karolinska, Stockholm, Sweden
[15] Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden
[16] Royal Brompton Hosp, London, England
[17] Imperial Coll, Natl Heart & Lung Inst, London, England
[18] Sorbonne Univ, La Pitie Salpetriere Hosp, Dept Intens Care Med, Paris, France
[19] Univ Florida Hlth, Congenital Heart Ctr, Univ Florida Shands Childrens Hosp, Div Cardiothorac Surg, Gainesville, FL USA
[20] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada
[21] Univ Queensland, Prince Charles Hosp, Crit Care Res Grp, Brisbane, Qld, Australia
[22] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD USA
关键词
Extracorporeal membrane oxygenation; Extracorporeal life support; Dual circulation; Differential oxygenation; Differential carbon dioxide; Mixing point; EXTRACORPOREAL MEMBRANE-OXYGENATION; VENTRICULAR DISTENSION; MANAGEMENT;
D O I
10.1007/s00134-024-07645-8
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
When native blood flow through the aorta from the adult heart and lungs meets retrograde blood flow from an artificial heart and lung during venoarterial extracorporeal membrane oxygenation (VA-ECMO), the result is the creation of two separate circulations on either side of the blood flow mixing point. This phenomenon is known as dual circulation and is characterized by different content of oxygen and carbon dioxide between the circulations. There is currently a lack of clarity surrounding the nomenclature to describe this physiologic phenomenon in VA-ECMO and thus we endeavor to name and define these terms to facilitate clear communication and proper clinical management of these patients.
引用
收藏
页码:1994 / 2004
页数:11
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