Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Venous Cannula Positioning in Arterial Deoxygenation During Veno-Arterial Extracorporeal Membrane Oxygenation-A Simulation Study and Case Report
KTH, Medicinsk bildteknik.ORCID iD: 0000-0002-1188-8098
Show others and affiliations
2017 (English)In: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 41, no 1, p. 75-81Article in journal (Refereed) Published
Abstract [en]

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is indicated in reversible life-threatening circulatory failure with or without respiratory failure. Arterial desaturation in the upper body is frequently seen in patients with peripheral arterial cannulation and severe respiratory failure. The importance of venous cannula positioning was explored in a computer simulation model and a clinical case was described. A closed-loop real-time simulation model has been developed including vascular segments, the heart with valves and pericardium. ECMO was simulated with a fixed flow pump and a selection of clinically relevant venous cannulation sites. A clinical case with no tidal volumes due to pneumonia and an arterial saturation of below 60% in the right hand despite VA-ECMO flow of 4 L/min was described. The case was compared with simulation data. Changing the venous cannulation site from the inferior to the superior caval vein increased arterial saturation in the right arm from below 60% to above 80% in the patient and from 64 to 81% in the simulation model without changing ECMO flow. The patient survived, was extubated and showed no signs of hypoxic damage. We conclude that venous drainage from the superior caval vein improves upper body arterial saturation during veno-arterial ECMO as compared with drainage solely from the inferior caval vein in patients with respiratory failure. The results from the simulation model are in agreement with the clinical scenario.

Place, publisher, year, edition, pages
2017. Vol. 41, no 1, p. 75-81
Keywords [en]
Cannulation, Differential hypoxia, Dual circulations, Extracorporeal membrane oxygenation, Harlequin syndrome, Modeling, Simulation, Venoarterial
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:hj:diva-37105DOI: 10.1111/aor.12700ISI: 000393318500013Scopus ID: 2-s2.0-84963626905OAI: oai:DiVA.org:hj-37105DiVA, id: diva2:1137623
Note

QC 20160613

Available from: 2016-06-13 Created: 2017-08-31 Last updated: 2017-08-31Bibliographically approved

Open Access in DiVA

fulltext(396 kB)125 downloads
File information
File name FULLTEXT01.pdfFile size 396 kBChecksum SHA-512
e5d1d75b2087d830e1551b882586ac37248247f58ae7bd67c38363ba2862201ccd5b5d2fe208a16ea98ed4b401d6b1a2987fe3d35da01d21dadd1be126335cdf
Type fulltextMimetype application/pdf

Other links

Publisher's full textScopus

Authority records BETA

Bjällmark, Anna

Search in DiVA

By author/editor
Bjällmark, AnnaBroomé, Michael
In the same journal
Artificial Organs
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
Total: 125 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 70 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf