Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model
(1) Background: Fluid resuscitation is a necessary part of therapeutic measures to maintain sufficient hemodynamics in extracorporeal membrane oxygenation (ECMO) circulation. In a post-hoc analysis, we aimed to investigate the impact of increased volume therapy in veno-arterial ECMO circulation on r...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/16/5330 |
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| author | Ilija Djordjevic Johanna Maier-Trauth Stephen Gerfer Mara Elskamp Thomas Muehlbauer Alexandra Maul Pia Rademann Borko Ivanov Ihor Krasivskyi Anton Sabashnikov Elmar Kuhn Ingo Slottosch Thorsten Wahlers Oliver Liakopoulos Antje Christin Deppe |
| author_facet | Ilija Djordjevic Johanna Maier-Trauth Stephen Gerfer Mara Elskamp Thomas Muehlbauer Alexandra Maul Pia Rademann Borko Ivanov Ihor Krasivskyi Anton Sabashnikov Elmar Kuhn Ingo Slottosch Thorsten Wahlers Oliver Liakopoulos Antje Christin Deppe |
| author_sort | Ilija Djordjevic |
| collection | DOAJ |
| description | (1) Background: Fluid resuscitation is a necessary part of therapeutic measures to maintain sufficient hemodynamics in extracorporeal membrane oxygenation (ECMO) circulation. In a post-hoc analysis, we aimed to investigate the impact of increased volume therapy in veno-arterial ECMO circulation on renal function and organ edema in a large animal model. (2) Methods: ECMO therapy was performed in 12 female pigs (Deutsche Landrasse × Pietrain) for 10 h with subsequent euthanasia. Applicable volume, in regard to the necessary maintenance of hemodynamics, was divided into moderate and extensive volume therapy (MVT/EVT) due to the double quantity of calculated physiologic urine output for the planned study period. Respiratory and hemodynamic data were measured continuously. Additionally, renal function and organ edema were assessed by blood and tissue samples. (3) Results: Four pigs received MVT, and eight pigs received EVT. After 10 h of ECMO circulation, no major differences were seen between the groups in regard to hemodynamic and respiratory data. The relative change in creatinine after 10 h of ECMO support was significantly higher in EVT (1.3 ± 0.3 MVT vs. 1.8 ± 0.5 EVT; <i>p</i> = 0.033). No major differences were evident for lung, heart, liver, and kidney samples in regard to organ edema in comparison of EVT and MVT. Bowel tissue showed a higher percentage of edema in EVT compared to MVT (77 ± 2% MVT vs. 80 ± 3% EVT; <i>p</i> = 0.049). (4) Conclusions: The presented data suggest potential deterioration of renal function and intestinal mucosa function by an increase in tissue edema due to volume overload in ECMO therapy. |
| first_indexed | 2024-03-09T10:55:49Z |
| format | Article |
| id | doaj.art-f1dc80550136435696c877952f1a6ac9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T10:55:49Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f1dc80550136435696c877952f1a6ac92023-12-01T01:42:31ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011216533010.3390/jcm12165330Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig ModelIlija Djordjevic0Johanna Maier-Trauth1Stephen Gerfer2Mara Elskamp3Thomas Muehlbauer4Alexandra Maul5Pia Rademann6Borko Ivanov7Ihor Krasivskyi8Anton Sabashnikov9Elmar Kuhn10Ingo Slottosch11Thorsten Wahlers12Oliver Liakopoulos13Antje Christin Deppe14Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDivision of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, 53721 Siegburg, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyFaculty of Medicine, University Hospital of Cologne, Experimental Medicine, University of Cologne, 50937 Cologne, GermanyFaculty of Medicine, University Hospital of Cologne, Experimental Medicine, University of Cologne, 50937 Cologne, GermanyDivision of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, 53721 Siegburg, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Otto-von-Guericke University Magdeburg, 39106 Magdeburg, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, GermanyDepartment of Cardiac Surgery, Kerckhoff-Clinic Bad Nauheim, Campus Kerckhoff, University of Giessen, 35392 Giessen, GermanyDepartment of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany(1) Background: Fluid resuscitation is a necessary part of therapeutic measures to maintain sufficient hemodynamics in extracorporeal membrane oxygenation (ECMO) circulation. In a post-hoc analysis, we aimed to investigate the impact of increased volume therapy in veno-arterial ECMO circulation on renal function and organ edema in a large animal model. (2) Methods: ECMO therapy was performed in 12 female pigs (Deutsche Landrasse × Pietrain) for 10 h with subsequent euthanasia. Applicable volume, in regard to the necessary maintenance of hemodynamics, was divided into moderate and extensive volume therapy (MVT/EVT) due to the double quantity of calculated physiologic urine output for the planned study period. Respiratory and hemodynamic data were measured continuously. Additionally, renal function and organ edema were assessed by blood and tissue samples. (3) Results: Four pigs received MVT, and eight pigs received EVT. After 10 h of ECMO circulation, no major differences were seen between the groups in regard to hemodynamic and respiratory data. The relative change in creatinine after 10 h of ECMO support was significantly higher in EVT (1.3 ± 0.3 MVT vs. 1.8 ± 0.5 EVT; <i>p</i> = 0.033). No major differences were evident for lung, heart, liver, and kidney samples in regard to organ edema in comparison of EVT and MVT. Bowel tissue showed a higher percentage of edema in EVT compared to MVT (77 ± 2% MVT vs. 80 ± 3% EVT; <i>p</i> = 0.049). (4) Conclusions: The presented data suggest potential deterioration of renal function and intestinal mucosa function by an increase in tissue edema due to volume overload in ECMO therapy.https://www.mdpi.com/2077-0383/12/16/5330ECMOfluid therapyfluid overload |
| spellingShingle | Ilija Djordjevic Johanna Maier-Trauth Stephen Gerfer Mara Elskamp Thomas Muehlbauer Alexandra Maul Pia Rademann Borko Ivanov Ihor Krasivskyi Anton Sabashnikov Elmar Kuhn Ingo Slottosch Thorsten Wahlers Oliver Liakopoulos Antje Christin Deppe Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model Journal of Clinical Medicine ECMO fluid therapy fluid overload |
| title | Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model |
| title_full | Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model |
| title_fullStr | Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model |
| title_full_unstemmed | Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model |
| title_short | Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model |
| title_sort | fluid management in veno arterial extracorporeal membrane oxygenation therapy analysis of an experimental pig model |
| topic | ECMO fluid therapy fluid overload |
| url | https://www.mdpi.com/2077-0383/12/16/5330 |
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