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

Park M, Mendes PV, Hirota AS, dos Santos EV, Costa EL, Azevedo LC - Rev Bras Ter Intensiva (2015 Apr-Jun)

Bottom Line: Blood flow/pump rotation ratio variations are negatively associated with transmembrane pressure (R2 = 0.5 for blood flow = 1500mL/minute and R2 = 0.4 for blood flow = 3500mL/minute, both with p < 0.001) and positively associated with CO2 transfer variations (R2 = 0.2 for sweep gas flow ≤ 6L/minute, p < 0.001, and R2 = 0.1 for sweep gas flow > 6L/minute, p = 0.006), and the blood flow/pump rotation ratio is not associated with O2 transfer variations (R2 = 0.01 for blood flow = 1500mL/minute, p = 0.19, and R2 = - 0.01 for blood flow = 3500 mL/minute, p = 0.46).Blood flow/pump rotation ratio variation is negatively associated with transmembrane pressure and positively associated with CO2 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.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Emergências Clínicas, Unidade de Terapia Intensiva, Hospital das Clínicas de São Paulo, São Paulo, SP, Brasil.

ABSTRACT

Objective: To analyze the correlations of the blood flow/pump rotation ratio and the transmembrane pressure, CO2 and O2 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 (R2 = 0.5 for blood flow = 1500mL/minute and R2 = 0.4 for blood flow = 3500mL/minute, both with p < 0.001) and positively associated with CO2 transfer variations (R2 = 0.2 for sweep gas flow ≤ 6L/minute, p < 0.001, and R2 = 0.1 for sweep gas flow > 6L/minute, p = 0.006), and the blood flow/pump rotation ratio is not associated with O2 transfer variations (R2 = 0.01 for blood flow = 1500mL/minute, p = 0.19, and R2 = - 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 CO2 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.

No MeSH data available.


Related in: MedlinePlus

Spider plot showing the relation between the variation of blood flow/rotationsper minute ratio and the determinants of its variation.
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f01: Spider plot showing the relation between the variation of blood flow/rotationsper minute ratio and the determinants of its variation.

Mentions: The mechanical determinants of the BFRR were as follows (with an R2 =0.82): TPM (beta coefficient = -0.003; p < 0.001), blood temperature (betacoefficient = 0.02; p < 0.001), ECMO blood flow (beta coefficient = -0.0002; p< 0.001), hemoglobin (beta coefficient = - 0.006; p = 0.05), and post-membranepressure (beta coefficient = -0.002; p < 0.001). The effect of BFRR variationaccording to the variation of each of the cited variables is shown in a spider plot(Figure 1). The BFRR varies according to theECMO blood flow in a non-linear fashion, as shown in figure 2. Among the paired samples of BFRR and TPM, there are severalduring the blood flow of 1500 and 3500L/minute (Figure3); therefore, the correlations between BFRR and TPM were measured usingthe two blood flows and are shown in the figure4.


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

Park M, Mendes PV, Hirota AS, dos Santos EV, Costa EL, Azevedo LC - Rev Bras Ter Intensiva (2015 Apr-Jun)

Spider plot showing the relation between the variation of blood flow/rotationsper minute ratio and the determinants of its variation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4489787&req=5

f01: Spider plot showing the relation between the variation of blood flow/rotationsper minute ratio and the determinants of its variation.
Mentions: The mechanical determinants of the BFRR were as follows (with an R2 =0.82): TPM (beta coefficient = -0.003; p < 0.001), blood temperature (betacoefficient = 0.02; p < 0.001), ECMO blood flow (beta coefficient = -0.0002; p< 0.001), hemoglobin (beta coefficient = - 0.006; p = 0.05), and post-membranepressure (beta coefficient = -0.002; p < 0.001). The effect of BFRR variationaccording to the variation of each of the cited variables is shown in a spider plot(Figure 1). The BFRR varies according to theECMO blood flow in a non-linear fashion, as shown in figure 2. Among the paired samples of BFRR and TPM, there are severalduring the blood flow of 1500 and 3500L/minute (Figure3); therefore, the correlations between BFRR and TPM were measured usingthe two blood flows and are shown in the figure4.

Bottom Line: Blood flow/pump rotation ratio variations are negatively associated with transmembrane pressure (R2 = 0.5 for blood flow = 1500mL/minute and R2 = 0.4 for blood flow = 3500mL/minute, both with p < 0.001) and positively associated with CO2 transfer variations (R2 = 0.2 for sweep gas flow ≤ 6L/minute, p < 0.001, and R2 = 0.1 for sweep gas flow > 6L/minute, p = 0.006), and the blood flow/pump rotation ratio is not associated with O2 transfer variations (R2 = 0.01 for blood flow = 1500mL/minute, p = 0.19, and R2 = - 0.01 for blood flow = 3500 mL/minute, p = 0.46).Blood flow/pump rotation ratio variation is negatively associated with transmembrane pressure and positively associated with CO2 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.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Emergências Clínicas, Unidade de Terapia Intensiva, Hospital das Clínicas de São Paulo, São Paulo, SP, Brasil.

ABSTRACT

Objective: To analyze the correlations of the blood flow/pump rotation ratio and the transmembrane pressure, CO2 and O2 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 (R2 = 0.5 for blood flow = 1500mL/minute and R2 = 0.4 for blood flow = 3500mL/minute, both with p < 0.001) and positively associated with CO2 transfer variations (R2 = 0.2 for sweep gas flow ≤ 6L/minute, p < 0.001, and R2 = 0.1 for sweep gas flow > 6L/minute, p = 0.006), and the blood flow/pump rotation ratio is not associated with O2 transfer variations (R2 = 0.01 for blood flow = 1500mL/minute, p = 0.19, and R2 = - 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 CO2 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.

No MeSH data available.


Related in: MedlinePlus