A comprehensive evaluation of hemodynamic energy production and circuit loss using four different ECMO arterial cannulae

• Published in: Artificial organs 2023-07, Vol.47 (7), p.1122-1132
• Main Authors: Heinsar, Silver, Bartnikowski, Nicole, Hartel, Gunter, Farah, Samia M., Seah, E‐Peng, Wu, Eric, Colombo, Sebastiano Maria, Semenzin, Clayton, Haymet, Andrew, Rätsep, Indrek, Pauls, Jo, Fraser, John F., Suen, Jacky Y.
• Format: Article
• Language: English
• Subjects: Amplitudes; Cannula; Cannulae; cardiogenic shock; Circuits; Data acquisition; Diastole; Energy; Energy transfer; Equipment Design; Extracorporeal Membrane Oxygenation; Flow velocity; Hemodynamics; Humans; mechanical circulatory support; Membranes; mock circulation loop; Models, Cardiovascular; Oxygenation; Oxygenators, Membrane; Pulsatile Flow; Systole; Unloading; Ventricle
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14523

Objective Pulsatile‐flow veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) has shown encouraging results for microcirculation resuscitation and left ventricle unloading in patients with refractory cardiogenic shock. We aimed to comprehensively assess different V‐A ECMO parameters and their contribution to hemodynamic energy production and transfer through the device circuit. Methods We used the i‐cor® ECMO circuit, which composed of Deltastream DP3 diagonal pump and i‐cor® console (Xenios AG), the Hilite 7000 membrane oxygenator (Xenios AG), venous and arterial tubing and a 1 L soft venous pseudo‐patient reservoir. Four different arterial cannulae (Biomedicus 15 and 17 Fr, Maquet 15 and 17 Fr) were used. For each cannula, 192 different pulsatile modes were investigated by adjusting flow rate, systole/diastole ratio, pulsatile amplitudes and frequency, yielding 784 unique conditions. A dSpace data acquisition system was used to collect flow and pressure data. Results Increasing flow rates and pulsatile amplitudes were associated with significantly higher hemodynamic energy production (both p