Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure

Hideshi Itoh, Shingo Ichiba, Yoshihito Ujike, Takuma Douguchi, Hideaki Obata, Syuji Inamori, Tatsuo Iwasaki, Shingo Kasahara, Shunji Sano, Akif Ündar

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08±0.86kg were divided into pulsatile (N=7) and nonpulsatile (N=7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house. Nonpulsatile ECMO was initiated at a flow rate of 140mL/kg/min for the first 30min with normal heart beating, with rectal temperature maintained at 36°C. Ventricular fibrillation was then induced with a 3.5-V alternating current to generate a cardiac dysfunction model. Using this model, we collected the data on pulsatile and nonpulsatile groups. The piglets were weaned off ECMO at the end of the experiment (180min after ECMO was initiated). The animals did not receive blood transfusions, inotropic drugs, or vasoactive drugs. Blood samples were collected to measure hemoglobin, methemoglobin, blood gases, electrolytes, and lactic acid levels. Hemodynamic energy was calculated using the Shepard's energy equivalent pressure. Near-infrared spectroscopy was used to monitor brain and kidney perfusion. The pulsatile ECMO group had a higher atrial pressure (systolic and mean), and significantly higher regional saturation at the brain level, than the nonpulsatile group (for both, P<0.05). Additionally, the pulsatile ECMO group had higher methemoglobin levels within the normal range than the nonpulsatile group. Our study demonstrated that pulsatile ECMO produces significantly higher hemodynamic energy and improves systemic microcirculation, compared with nonpulsatile ECMO in acute cardiac failure.

Original languageEnglish (US)
Pages (from-to)19-26
Number of pages8
JournalArtificial organs
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Microcirculation
Extracorporeal Membrane Oxygenation
Oxygenation
Hemodynamics
Heart Failure
Membranes
Methemoglobin
Blood
Brain
Membrane Oxygenators
Oxygenators
Pulsatile Flow
Atrial Pressure
Near-Infrared Spectroscopy
Pulsatile flow
Gas generators
Near infrared spectroscopy
Ventricular Fibrillation
Centrifugal pumps
Hemoglobin

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this

Itoh, Hideshi ; Ichiba, Shingo ; Ujike, Yoshihito ; Douguchi, Takuma ; Obata, Hideaki ; Inamori, Syuji ; Iwasaki, Tatsuo ; Kasahara, Shingo ; Sano, Shunji ; Ündar, Akif. / Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure. In: Artificial organs. 2016 ; Vol. 40, No. 1. pp. 19-26.
@article{469f425a5a3149e28a4d015f9d9b7d5d,
title = "Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure",
abstract = "The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08±0.86kg were divided into pulsatile (N=7) and nonpulsatile (N=7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house. Nonpulsatile ECMO was initiated at a flow rate of 140mL/kg/min for the first 30min with normal heart beating, with rectal temperature maintained at 36°C. Ventricular fibrillation was then induced with a 3.5-V alternating current to generate a cardiac dysfunction model. Using this model, we collected the data on pulsatile and nonpulsatile groups. The piglets were weaned off ECMO at the end of the experiment (180min after ECMO was initiated). The animals did not receive blood transfusions, inotropic drugs, or vasoactive drugs. Blood samples were collected to measure hemoglobin, methemoglobin, blood gases, electrolytes, and lactic acid levels. Hemodynamic energy was calculated using the Shepard's energy equivalent pressure. Near-infrared spectroscopy was used to monitor brain and kidney perfusion. The pulsatile ECMO group had a higher atrial pressure (systolic and mean), and significantly higher regional saturation at the brain level, than the nonpulsatile group (for both, P<0.05). Additionally, the pulsatile ECMO group had higher methemoglobin levels within the normal range than the nonpulsatile group. Our study demonstrated that pulsatile ECMO produces significantly higher hemodynamic energy and improves systemic microcirculation, compared with nonpulsatile ECMO in acute cardiac failure.",
author = "Hideshi Itoh and Shingo Ichiba and Yoshihito Ujike and Takuma Douguchi and Hideaki Obata and Syuji Inamori and Tatsuo Iwasaki and Shingo Kasahara and Shunji Sano and Akif {\"U}ndar",
year = "2016",
month = "1",
day = "1",
doi = "10.1111/aor.12588",
language = "English (US)",
volume = "40",
pages = "19--26",
journal = "Artificial Organs",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "1",

}

Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure. / Itoh, Hideshi; Ichiba, Shingo; Ujike, Yoshihito; Douguchi, Takuma; Obata, Hideaki; Inamori, Syuji; Iwasaki, Tatsuo; Kasahara, Shingo; Sano, Shunji; Ündar, Akif.

In: Artificial organs, Vol. 40, No. 1, 01.01.2016, p. 19-26.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure

AU - Itoh, Hideshi

AU - Ichiba, Shingo

AU - Ujike, Yoshihito

AU - Douguchi, Takuma

AU - Obata, Hideaki

AU - Inamori, Syuji

AU - Iwasaki, Tatsuo

AU - Kasahara, Shingo

AU - Sano, Shunji

AU - Ündar, Akif

PY - 2016/1/1

Y1 - 2016/1/1

N2 - The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08±0.86kg were divided into pulsatile (N=7) and nonpulsatile (N=7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house. Nonpulsatile ECMO was initiated at a flow rate of 140mL/kg/min for the first 30min with normal heart beating, with rectal temperature maintained at 36°C. Ventricular fibrillation was then induced with a 3.5-V alternating current to generate a cardiac dysfunction model. Using this model, we collected the data on pulsatile and nonpulsatile groups. The piglets were weaned off ECMO at the end of the experiment (180min after ECMO was initiated). The animals did not receive blood transfusions, inotropic drugs, or vasoactive drugs. Blood samples were collected to measure hemoglobin, methemoglobin, blood gases, electrolytes, and lactic acid levels. Hemodynamic energy was calculated using the Shepard's energy equivalent pressure. Near-infrared spectroscopy was used to monitor brain and kidney perfusion. The pulsatile ECMO group had a higher atrial pressure (systolic and mean), and significantly higher regional saturation at the brain level, than the nonpulsatile group (for both, P<0.05). Additionally, the pulsatile ECMO group had higher methemoglobin levels within the normal range than the nonpulsatile group. Our study demonstrated that pulsatile ECMO produces significantly higher hemodynamic energy and improves systemic microcirculation, compared with nonpulsatile ECMO in acute cardiac failure.

AB - The objective of this study was to compare the effects of pulsatile and nonpulsatile extracorporeal membrane oxygenation (ECMO) on hemodynamic energy and systemic microcirculation in an acute cardiac failure model in piglets. Fourteen piglets with a mean body weight of 6.08±0.86kg were divided into pulsatile (N=7) and nonpulsatile (N=7) ECMO groups. The experimental ECMO circuit consisted of a centrifugal pump, a membrane oxygenator, and a pneumatic pulsatile flow generator system developed in-house. Nonpulsatile ECMO was initiated at a flow rate of 140mL/kg/min for the first 30min with normal heart beating, with rectal temperature maintained at 36°C. Ventricular fibrillation was then induced with a 3.5-V alternating current to generate a cardiac dysfunction model. Using this model, we collected the data on pulsatile and nonpulsatile groups. The piglets were weaned off ECMO at the end of the experiment (180min after ECMO was initiated). The animals did not receive blood transfusions, inotropic drugs, or vasoactive drugs. Blood samples were collected to measure hemoglobin, methemoglobin, blood gases, electrolytes, and lactic acid levels. Hemodynamic energy was calculated using the Shepard's energy equivalent pressure. Near-infrared spectroscopy was used to monitor brain and kidney perfusion. The pulsatile ECMO group had a higher atrial pressure (systolic and mean), and significantly higher regional saturation at the brain level, than the nonpulsatile group (for both, P<0.05). Additionally, the pulsatile ECMO group had higher methemoglobin levels within the normal range than the nonpulsatile group. Our study demonstrated that pulsatile ECMO produces significantly higher hemodynamic energy and improves systemic microcirculation, compared with nonpulsatile ECMO in acute cardiac failure.

UR - http://www.scopus.com/inward/record.url?scp=84956840527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84956840527&partnerID=8YFLogxK

U2 - 10.1111/aor.12588

DO - 10.1111/aor.12588

M3 - Article

C2 - 26526784

AN - SCOPUS:84956840527

VL - 40

SP - 19

EP - 26

JO - Artificial Organs

JF - Artificial Organs

SN - 0160-564X

IS - 1

ER -