The potential of accurate SvO2 monitoring during venovenous extracorporeal membrane oxygenation: an in vitro model using ultrasound dilution

Perfusion
Joshua L WalkerEdward Darling

Abstract

Some degree of recirculation occurs during venovenous extracorporeal membrane oxygenation (VV ECMO) which, (1) reduces oxygen (O2) delivery, and (2) renders venous line oxygen saturation monitoring unreliable as an index of perfusion adequacy. Ultrasound dilution allows clinicians to rapidly monitor and quantify the percent of recirculation that is occurring during VV ECMO. The purpose of this paper is to test whether accurate patient mixed venous oxygen saturation (SvO2) can be calculated once recirculation is determined. It is hypothesized that it is possible to derive patient mixed venous saturations by integrating recirculation data with the ECMO circuit arterial and venous line oxygen saturation data. A test system containing sheep blood adjusted to three venous saturations (low-30%, med-60%, high-80%) was interfaced via a mixing chamber with a standard VV ECMO circuit. Recirculation, arterial line and venous line oxygen saturations were measured and entered into a derived equation to calculate the mixed venous saturation. The resulting value was compared to the actual mixed venous saturation. Recirculation was held constant at 30.5 +/- 2.0% for all tests. A linear regression comparison of "actual" versus "calculated" mixe...Continue Reading

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Citations

Nov 26, 2014·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Darryl AbramsDaniel Brodie
Nov 5, 2016·Journal of Critical Care·Ashleigh XiePaul Forrest
Nov 1, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Oscar PalmérMikael Broman
Dec 29, 2009·The International Journal of Artificial Organs·Steven J LindstromRobert F Salamonsen

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