Hála P, Mlček M, Ošťádal P, Janák D, Popková M, Bouček T, Lacko S, Kudlička J, Neužil P, Kittnar O
Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic; Department of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Physiol Res. 2016 Dec 22;65(Suppl 5):S621-S631. doi: 10.33549/physiolres.933532.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in treatment of decompensated heart failure. Our aim was to investigate its effects on regional perfusion and tissue oxygenation with respect to extracorporeal blood flow (EBF). In five swine, decompensated low-output chronic heart failure was induced by long-term rapid ventricular pacing. Subsequently, VA ECMO was introduced and left ventricular (LV) volume, aortic blood pressure, regional arterial flow and tissue oxygenation were continuously recorded at different levels of EBF. With increasing EBF from minimal to 5 l/min, mean arterial pressure increased from 47+/-22 to 84+/-12 mm Hg (P<0.001) and arterial blood flow increased in carotid artery from 211+/-72 to 479+/-58 ml/min (P<0.01) and in subclavian artery from 103+/-49 to 296+/-54 ml/min (P<0.001). Corresponding brain and brachial tissue oxygenation increased promptly from 57+/-6 to 74+/-3 % and from 37+/-6 to 77+/-6 %, respectively (both P<0.01). Presented results confirm that VA ECMO is a capable form of heart support. Regional arterial flow and tissue oxygenation suggest that partial circulatory support may be sufficient to supply brain and peripheral tissue by oxygen.
静脉-动脉体外膜肺氧合（VA ECMO）广泛应用于失代偿性心力衰竭的治疗。我们的目的是研究其在体外血流量（EBF）方面对局部灌注和组织氧合的影响。在5头猪中，通过长期快速心室起搏诱导失代偿性低输出慢性心力衰竭。随后，引入VA ECMO，并在不同EBF水平连续记录左心室（LV）容积、主动脉血压、局部动脉血流和组织氧合。随着EBF从最小值增加到5升/分钟，平均动脉压从47±22毫米汞柱增加到84±12毫米汞柱（P<0.001），颈动脉血流从211±72毫升/分钟增加到479±58毫升/分钟（P<0.01），锁骨下动脉血流从103±49毫升/分钟增加到296±54毫升/分钟（P<0.001）。相应的脑和肱部组织氧合分别迅速从57±6%增加到74±3%和从37±6%增加到77±6%（均P<0.01）。呈现的结果证实VA ECMO是一种有效的心脏支持形式。局部动脉血流和组织氧合表明，部分循环支持可能足以通过氧气供应脑和外周组织。
