A quantified description of the interactions between the native cardiovascular system and femoro-femoral versus femoro-axillary extracorporeal life support using descending thoracic aorta velocity time integral

被引：7

作者：

Andrei, Stefan ^{[1
]}

Tran-Dinh, Alexy ^{[1
,2
]}

Provenchere, Sophie ^{[1
,3
]}

Lortat-Jacob, Brice ^{[1
]}

Ghodbane, Walid ^{[4
]}

Montravers, Philippe ^{[1
,5
]}

Longrois, Dan ^{[1
,2
]}

机构：

[1] Univ Paris Sorbonne, CHU Bichat Claude Bernard, AP HP, Dept Anesthesie Reanimat, 46 Rue Henri Huchard, F-75877 Paris 18, France

[2] CHU Bichat Claude Bernard, Unite INSERM, UMR 1148, Paris, France

[3] CHU Bichat Claude Bernard, INSERM Ctr Invest Clin 1425, Paris, France

[4] Univ Paris Sorbonne, CHU Bichat Claude Bernard, AP HP, Serv Chirurg Cardiaque, Paris, France

[5] UFR Med Xavier Bichat, Unite INSERM UMR 1152, Paris, France

来源：

ARTIFICIAL ORGANS | 2019年 / 43卷 / 07期

关键词：

cannulation; descending thoracic aorta; DTA VTI; extracorporeal life support; extracorporeal membrane oxygenation; femoro-axillary; femoro-femoral; velocity time integral; weaning; MEMBRANE-OXYGENATION; MANAGEMENT; CANNULATION; ECMO; ECHOCARDIOGRAPHY; PITFALLS;

D O I：

10.1111/aor.13411

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Extracorporeal life support (ECLS) is an important tool in managing severe cardio-circulatory and respiratory failures. The axillary and the femoral sites are the most frequently used for arterial cannulation. There is no current evidence favoring one site over the other. We tested the hypothesis that the axillary and femoral arterial cannulation site may have different effects on left ventricular (LV) outflow. Seven patients with femoro-axillary ECLS and 4 patients with femoro-femoral ECLS were prospectively studied using the Pulse-wave Doppler (PWD) velocity time integral (VTI) in the descending thoracic aorta (DTA VTI) at different short-time variations of ECLS flow rates during the ECLS weaning process. The measurements were safe and feasible in all patients. We found a directly proportional correlation between DTA VTI and ECLS flow rate for femoro-axillary cannulation (P < 0.05) and an inversely proportional correlation in the case of femoro-femoral cannulation (P < 0.05). This is the first reported utilization of DTA VTI during ECLS that could improve our understanding of the LV-aorta interactions in patients with ECLS. DTA VTI could be used as a tool, guiding weaning from ECLS.

引用

页码：647 / 655

页数：9

共 33 条

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