Department of Cardiothoracic Surgery, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Sci Rep. 2020 Nov 6;10(1):19275. doi: 10.1038/s41598-020-76299-5.
Circulating compounds such as drugs and nutritional components might adhere to the oxygenator fibers and tubing during ECMO support. This study evaluated the amount of nutritional supplements adsorbed to the ECMO circuit under controlled ex vivo conditions. Six identical ECMO circuits were primed with fresh human whole blood and maintained under physiological conditions at 36 °C for 24 h. A dose of nutritional supplement calculated for a 70 kg patient was added. 150 mL volume was drawn from the priming bag for control samples and kept under similar conditions. Blood samples were obtained at predetermined time points and analyzed for concentrations of vitamins, minerals, lipids, and proteins. Data were analyzed using mixed models with robust standard errors. No significant differences were found between the ECMO circuits and the controls for any of the measured variables: cobalamin, folate, vitamin A, glucose, minerals, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides or total proteins. There was an initial decrease and then an increase in the concentration of cobalamin and folate. Vitamin A concentrations decreased in both groups over time. There was a decrease in concentration of glucose and an increased concentration of lactate dehydrogenase over time in both groups. There were no significant alterations in the concentrations of nutritional supplements in an ex vivo ECMO circuit compared to control samples. The time span of this study was limited, thus, clinical studies over a longer period of time are needed.
在 ECMO 支持期间，循环化合物（如药物和营养成分）可能会附着在氧合器纤维和管路上。本研究评估了在受控的离体条件下营养补充剂吸附到 ECMO 回路的量。六个相同的 ECMO 回路用新鲜的全血预充，并在 36°C 的生理条件下维持 24 小时。计算出适合 70kg 患者的营养补充剂量，并添加到 ECMO 回路中。从预充袋中抽取 150ml 体积作为对照样品，并保持在类似条件下。在预定的时间点采集血液样本，并分析维生素、矿物质、脂质和蛋白质的浓度。使用具有稳健标准误差的混合模型分析数据。对于任何测量变量，ECMO 回路与对照之间均无显著差异：钴胺素、叶酸、维生素 A、葡萄糖、矿物质、HDL 胆固醇、LDL 胆固醇、总胆固醇、甘油三酯或总蛋白。钴胺素和叶酸的浓度最初下降，然后增加。两组维生素 A 的浓度随时间推移而降低。两组葡萄糖浓度随时间推移而降低，乳酸脱氢酶浓度升高。与对照样本相比，体外 ECMO 回路中营养补充剂的浓度没有明显变化。本研究的时间跨度有限，因此需要进行更长时间的临床研究。
