An experimental study on pumpless extracorporeal membrane oxygenation (ECMO) support in a canine model.
This study was carried out to determine whether an extracorporeal membrane oxygenation (ECMO) support could be sufficiently conducted by the right ventricle alone from the viewpoint of the hemodynamics and blood gas state. Six infant dogs underwent a bypass between the left pulmonary artery and left atrium with an in-line oxygenator after a left pneumonectomy. Partial ECMO support was conducted simply by opening the circuit, and total ECMO support was conducted by ligating the right pulmonary artery. After the establishment of partial ECMO, approximately one-third of the right ventricular output was passively shunted through the bypass circuit, and the cardiac index and central venous pressure did not change. The mean pulmonary arterial pressures increased significantly. After a complete ligation of the right pulmonary artery, all 6 dogs survived for 12 h, but the cardiac output and blood pressure decreased significantly. The blood gas state was sufficiently maintained throughout the experiment. The results suggest the possibility of using the pumpless ECMO support. However, the flow resistance of the membrane oxygenator proved to still be too high for use in a total pumpless ECMO. Further studies on long-term ECMO and the development of a membrane oxygenator with a considerably low flow-resistance are needed.
Tamesue
Kiyokazu
K
Department of Cancer and Thracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. k.tame@f7.dion.ne.jp
Ichiba
Shingo
S
Nawa
Sugato
S
Shimizu
Nobuyoshi
N
D000818:Animals; D000831:Animals, Newborn; D001187:Artificial Organs; D016275:Atrial Function / Q000502:physiology; D001784:Blood Gas Analysis; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D004285:Dogs; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D015918:Infusion Pumps, Implantable; D023421:Models, Animal; D010107:Oxygenators, Membrane; D011013:Pneumonectomy; D011651:Pulmonary Artery / Q000502:physiology; D012131:Respiratory Insufficiency / Q000628:therapy; D016276:Ventricular Function