학술논문
Effect of flow change on brain injury during an experimental model of differential hypoxaemia in cardiogenic shock supported by extracorporeal membrane oxygenation
Document Type
article
Author
Sacha Rozencwajg; Silver Heinsar; Karin Wildi; Jae‐Seung Jung; Sebastiano Maria Colombo; Chiara Palmieri; Kei Sato; Carmen Ainola; Xiaomeng Wang; Gabriella Abbate; Noriko Sato; Wayne B. Dyer; Samantha Livingstone; Leticia Helms; Nicole Bartnikowski; Mahe Bouquet; Margaret R. Passmore; Kieran Hyslop; Bruno Vidal; Janice D. Reid; Daniel McGuire; Emily S. Wilson; Indrek Rätsep; Roberto Lorusso; Matthieu Schmidt; Jacky Y. Suen; Gianluigi Li Bassi; John F. Fraser
Source
Scientific Reports, Vol 13, Iss 1, Pp 1-11 (2023)
Subject
Language
English
ISSN
2045-2322
Abstract
Abstract Differential hypoxaemia (DH) is common in patients supported by femoral veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and can cause cerebral hypoxaemia. To date, no models have studied the direct impact of flow on cerebral damage. We investigated the impact of V-A ECMO flow on brain injury in an ovine model of DH. After inducing severe cardiorespiratory failure and providing ECMO support, we randomised six sheep into two groups: low flow (LF) in which ECMO was set at 2.5 L min−1 ensuring that the brain was entirely perfused by the native heart and lungs, and high flow (HF) in which ECMO was set at 4.5 L min−1 ensuring that the brain was at least partially perfused by ECMO. We used invasive (oxygenation tension—PbTO2, and cerebral microdialysis) and non-invasive (near infrared spectroscopy—NIRS) neuromonitoring, and euthanised animals after five hours for histological analysis. Cerebral oxygenation was significantly improved in the HF group as shown by higher PbTO2 levels (+ 215% vs − 58%, p = 0.043) and NIRS (67 ± 5% vs 49 ± 4%, p = 0.003). The HF group showed significantly less severe brain injury than the LF group in terms of neuronal shrinkage, congestion and perivascular oedema (p