Key result
Venoarterial extracorporeal membrane oxygenation increased left ventricular volumes and reduced left ventricular function comparably, irrespective of peripheral or central cannulation site in pigs.
Why the study?
Does peripheral versus central cannulation for VA-ECMO differentially affect left ventricular function in a porcine model?
RCT (n=10)
randomized
Does peripheral versus central cannulation for VA-ECMO differentially affect left ventricular function in a porcine model?
In a porcine model, VA-ECMO induces left ventricular dysfunction and dilatation regardless of whether peripheral or central cannulation is used.
VA-ECMO impairs LV function similarly with peripheral or central cannulation in pigs; leaves open clinical relevance.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has experienced an increased use in acute cardiac failure. There are some reports on negative effects of VA-ECMO on cardiac function, such as left ventricular (LV) dilatation and cardiac stun, but the support in the literature is scarce. This study investigates the effects of experimental VA-ECMO on LV function in both peripheral and central cannulation. Ten pigs were randomized to VA-ECMO by either peripheral cannulation through the femoral vessels or central cannulation in the right atrium and ascending aorta. Left ventricular performance was measured with pressure-volume catheters during 5 hours of VA-ECMO. The LV end-diastolic and end-systolic volumes increased comparably in both groups during ECMO. Left ventricular ejection fraction, stroke work, and maximum rate of pressure change decreased comparably in both groups as a function of time on ECMO. The site of cannulation had no impact on the LV response to ECMO. In conclusion, VA-ECMO increased LV volumes and reduced LV function, irrespective of cannulation site in this experimental model. Reduced LV ejection fraction and stroke work indicated LV dysfunction during ECMO.
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Schiller et al. (2016) conducted an RCT in experimental VA-ECMO (n=10). Peripheral cannulation VA-ECMO vs. Central cannulation VA-ECMO was evaluated on Left ventricular performance. Venoarterial extracorporeal membrane oxygenation increased left ventricular volumes and reduced left ventricular function comparably, irrespective of peripheral or central cannulation site in pigs.
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