Chonnam National University Graduate School, Gwangju, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-ro Donggu, Gwangju, Republic of Korea.
Sci Rep. 2022 Dec 23;12(1):22181. doi: 10.1038/s41598-022-26145-7.
Extracorporeal membrane oxygenation (ECMO) may be a viable salvage therapy in selected patients with septic shock. As ECMO use increases, we studied left ventricular (LV) performance during sepsis with and without ECMO using a pressure-volume (PV) loop in a murine model and aimed to understand LV hemodynamics in septic shock with ECMO. The rats were divided into Group 1 (ECMO applied to healthy rats), Group 2 (ECMO for septic rats), Group 3 (Controls, n = 20) and Group 4 (Sepsis induction only, n = 20). The cardiac parameters include end-diastolic volume (EDV), end-systolic volume (ESV), end-diastolic pressure (EDP), and end-systolic pressure (ESP), ejection fraction (EF), end-systolic elastance (Ees), diastolic time constant (Tau) index, arterial elastance (Ea), pressure-volume area (PVA), stroke work (SW), and potential energy (PE). We compared the changes of parameters in all groups. A total of 74 rats were included in the analyses. After 2 h on ECMO, Group 2 was associated with significant increases in ESP, EDV, ESV, PVA, PE, and SW. The difference ratio of PE and PVA was significantly higher in Group 2 compared to Group 1 (P < 0.01). In conclusion, myocardial oxygen consumption was higher in septic shock with ECMO than in controls.
体外膜肺氧合(ECMO)可能是治疗感染性休克患者的一种可行的挽救性治疗方法。随着 ECMO 的应用增加,我们在鼠模型中使用压力-容积(PV)环研究了感染性休克合并和不合并 ECMO 时的左心室(LV)功能,并旨在了解 ECMO 治疗感染性休克时的 LV 血流动力学。将大鼠分为 4 组:第 1 组(ECMO 应用于健康大鼠)、第 2 组(ECMO 用于感染性休克大鼠)、第 3 组(对照组,n = 20)和第 4 组(仅诱导感染性休克,n = 20)。心脏参数包括舒张末期容积(EDV)、收缩末期容积(ESV)、舒张末期压力(EDP)和收缩末期压力(ESP)、射血分数(EF)、收缩末期弹性(Ees)、舒张时间常数(Tau)指数、动脉弹性(Ea)、压力-容积面积(PVA)、每搏功(SW)和势能(PE)。我们比较了所有组参数的变化。共有 74 只大鼠纳入分析。在 ECMO 上 2 小时后,第 2 组的 ESP、EDV、ESV、PVA、PE 和 SW 显著增加。与第 1 组相比,第 2 组的 PE 和 PVA 的差异比明显更高(P < 0.01)。结论:与对照组相比,ECMO 治疗感染性休克时心肌耗氧量更高。