Luo Jing-Chao, Zhang Yi-Jie, Hou Jun-Yi, Luo Ming-Hao, Liu Kai, Tu Guo-Wei, Luo Zhe
Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Medical College, Fudan University, Shanghai, China.
Front Med (Lausanne). 2022 Sep 8;9:989197. doi: 10.3389/fmed.2022.989197. eCollection 2022.
The cardiac function reserve is crucial for the successful weaning of V-A ECMO. During the V-A ECMO weaning phase, the gradual reduction in pump flow converts the blood flow originally driven by the pump to native cardiac output and also transforms afterload (caused by retrograde flow) into ventricular preload, thus introducing a "flow challenge" to the native heart. In this perspective, we propose to use this flow challenge as a test to simulate the preload-to-afterload conversion to assess cardiac functional reserve quantitatively. With this short article we offer the hemodynamic and clinical aspects regarding the flow challenge test.
心功能储备对于成功撤离静脉-动脉体外膜肺氧合（V-A ECMO）至关重要。在V-A ECMO撤离阶段，泵流量逐渐减少，使原本由泵驱动的血流转变为自身心输出量，并将（由逆向血流引起的）后负荷转变为心室前负荷，从而给自身心脏带来“流量挑战”。从这个角度来看，我们建议将这种流量挑战作为一种测试，以模拟前负荷向后负荷的转换，从而定量评估心功能储备。在这篇短文中，我们介绍了有关流量挑战测试的血流动力学和临床方面的情况。
