title: Experimental Venoarterial Extracorporeal Membrane Oxygenation Induces Left Ventricular Dysfunction.
abstract: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has experienced an increased use in acute cardiac failure. There are some reports on negative effects of VA-ECMO on cardiac function, such as left ventricular (LV) dilatation and cardiac stun, but the support in the literature is scarce. This study investigates the effects of experimental VA-ECMO on LV function in both peripheral and central cannulation. Ten pigs were randomized to VA-ECMO by either peripheral cannulation through the femoral vessels or central cannulation in the right atrium and ascending aorta. Left ventricular performance was measured with pressure-volume catheters during 5 hours of VA-ECMO. The LV end-diastolic and end-systolic volumes increased comparably in both groups during ECMO. Left ventricular ejection fraction, stroke work, and maximum rate of pressure change decreased comparably in both groups as a function of time on ECMO. The site of cannulation had no impact on the LV response to ECMO. In conclusion, VA-ECMO increased LV volumes and reduced LV function, irrespective of cannulation site in this experimental model. Reduced LV ejection fraction and stroke work indicated LV dysfunction during ECMO.
authors.affiliation: From the Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Schiller
authors.forename: Per
authors.initials: P
authors.lastname: Vikholm
authors.forename: Laila
authors.initials: L
authors.lastname: Hellgren
mesh_terms: D000818:Animals; D001011:Aorta / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005263:Femoral Artery / Q000601:surgery; D005268:Femoral Vein / Q000601:surgery; D006325:Heart Atria / Q000601:surgery; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology*; D011897:Random Allocation; D013552:Swine; D016277:Ventricular Function, Left / Q000502:physiology*