High oxygen delivery and extraction by perfluorocarbon-primed extracorporeal membrane oxygenation do not prevent anaerobic metabolism in rabbits.
OBJECTIVE
This study was designed to evaluate the advantage of perfluorocarbon (PFC) emulsion priming for venoarterial extracorporeal membrane oxygenation (ECMO) by comparison with hydroxyethyl starch (HES) solution in rabbits (2.8 to 3.9 kg).


RESULTS
ECMO initiation was accompanied by a profound decrease in hematocrit (from 40.1% to 14.9%) in both groups. The arterial and the right atrial oxygen contents in the PFC group (n = 4; 38.5 and 11.5 mL/dL) were greater than in the HES group (n = 5; 7.0 and 5.1 mL/dL). Right atrial oxygen tension in the PFC group increased at the beginning of ECMO (from 38.4 to 51.2 mm Hg; P = .031) and remained higher than in the HES group for 60 minutes. These results indicate that oxygen supply and extraction in the PFC group were much greater than in the HES group. However, plasma lactate increased progressively during the 120-minute ECMO procedure in both groups (from 1.8 to 14.5 in the HES group, and from 2.3 to 12.2 in the PFC group).


CONCLUSIONS
Perfluorocarbon priming for ECMO, although providing high oxygen delivery and extraction, does not prevent anaerobic metabolism.
Iwao
Y
Y
Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan.
Tashiro
M
M
Iijima
T
T
Masuda
J
J
Sankawa
H
H
D000693:Anaerobiosis; D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D005466:Fluorocarbons; D006400:Hematocrit; D006895:Hydroxyethyl Starch Derivatives; D019344:Lactic Acid / Q000097:blood; D008297:Male; D010100:Oxygen / Q000097:blood / Q000378:metabolism*; D010313:Partial Pressure; D019289:Pyruvic Acid / Q000097:blood; D011817:Rabbits
D005466:Fluorocarbons; D006895:Hydroxyethyl Starch Derivatives; D002245:Carbon Dioxide; D019344:Lactic Acid; D019289:Pyruvic Acid; D010100:Oxygen