Abstract
BackgroundPeripheral ECMO is an effective cardiopulmonary support in clinical. The perfusion level could directly influence the performances and complications. However, there are few studies on the effects of the perfusion level on hemodynamics of peripheral ECMO.MethodsThe geometric model of cardiovascular system with peripheral ECMO was established. The blood assist index was used to classify the perfusion level of the ECMO. The flow pattern from the aorta to the femoral artery and their branches, blood flow rate from aorta to brain and limbs, flow interface, harmonic index of blood flow, wall shear stress and oscillatory shear index were chosen to evaluate the hemodynamic effects of peripheral ECMO.ResultsThe results demonstrated that the flow rate of aorta outlets increased and perfusion condition had been improved. And the average flow to the upper limbs and brain has a positive correlation with BAI (r = 0.037, p < 0.05), while there is a negative correlation with lower limbs (r = − 0.054, p < 0.05). The HI has negative correlation with BAI (p < 0.05, r < 0). The blood interface is further from the heart with the BAI decrease. And the average WSS has negative correlation with BAI (p < 0.05, r = − 0.983) at the bifurcation of femoral aorta and has positive correlation with BAI (p < 0.05, r = 0.99) at the inner aorta. The OSI under different BAI is higher (reaching 0.4) at the inner wall of the aortic arch, the descending aorta and the femoral access.ConclusionsThe pathogenesis of peripheral ECMO with different perfusion levels varies; its further research will be thorough and extensive.
Highlights
Peripheral ECMO is an effective cardiopulmonary support in clinical
Peripheral ECMO is one of the Veno-arterial extra corporeal membrane oxygenation (VA ECMO) mode which usually has an arterial cannula placed into the right femoral artery for infusion and a venous cannula placed in the right common femoral vein for extraction [5,6,7,8]
High blood flow velocity from the ECMO cannula flow may result in high wall shear stress of local vascular and high blood pressure which may result in vascular complication [10]
Summary
Peripheral ECMO is an effective cardiopulmonary support in clinical. There are few studies on the effects of the perfusion level on hemodynamics of periph‐ eral ECMO. Veno-arterial extra corporeal membrane oxygenation (VA ECMO) is a common treatment for respiratory failure and heart failure clinically [1,2,3,4]. Limb ischemic is a common complication with peripheral ECMO and more than half of our patients developed it [15,16,17]. Peripheral ECMO may not well supply the coronary arteries and proximal aorta arch branches and these vessels may be filled with poorly oxygenated blood by the heart if the patient has respiratory failure. The perfusion amount is based on doctors’ own experience, the hemodynamic performances under different perfusion level of ECMO have been less studied
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
