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- W2079100812 abstract "Introduction: Recirculation (R), the shunting of arterial blood back into to the venous lumen, commonly occurs during veno-venous extracorporeal membrane oxygenation (VV-ECMO) and renders the monitoring of the venous line oxygen saturation no longer reflective of patient mixed venous oxygen saturation (S V O 2 ). Previously, we failed to prove the hypothesis that, once R is known, it is possible to calculate the S V O 2 of a patient on VV-ECMO. We hypothesize that we can calculate S V O 2 during VV-ECMO if we account for and add an additional correction factor to our model for dissolved oxygen content. Therefore, the purpose of this study is to derive a more accurate model that will allow clinicians to determine S V O 2 during VV-ECMO when ultrasound dilution is being used to quantify R. Methods : Using an extracorporeal circuit primed with fresh porcine blood, two stocks of blood were produced; (1) arterial blood (AB), and (2) venous blood (VB). To mimic recirculation, the AB and VB were mixed together in precise ratios using syringes and a stopcock manifold. Six paired stock AB/VB sets were prepared. Two sets were mixed at 20% R increments and 4 sets were mixed at 10% R increments. The partial pressure of oxygen (pO 2 ) and oxygen (O 2 ) saturation of the stock blood and resultant mixed blood was determined. The original model was modified by modeling the residual errors with linear regression. Results: When using the original model, as the partial pressure of arterial oxygen (P a O 2 ) of the stock AB increased, the calculated S V O 2 was higher than actual, especially at higher R levels. An iteration of the original model incorporating the P a O 2 level (low, medium, high) and R was derived to fit the data. Conclusions : The original model using R and circuit saturations for the calculation of S V O 2 in VV-ECMO patients is an oversimplification that fails to consider the influence of the high pO 2 of arterial blood during therapy. In the future, further improvements in this model will allow clinicians accurately to calculate S V O 2 in conjunction with recirculation measurements." @default.
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- W2079100812 date "2009-09-01" @default.
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- W2079100812 title "Calculating mixed venous saturation during veno-venous extracorporeal membrane oxygenation" @default.
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- W2079100812 doi "https://doi.org/10.1177/0267659109354790" @default.
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