Evidence map›Paper›PMID 35467225›Full record

ArticleIntensive care medicine experimental2022

Lung perfusion during veno-venous extracorporeal membrane oxygenation in a model of hypoxemic respiratory failure.

Pedro Vitale Mendes, Marcelo Park, Luciano Cesar Pontes de Azevedo, Caio Cesar Araujo Morais, Marcelo Brito Passos Amato, Eduardo Leite Vieira Costa

Open access · goldAbstract read
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Article in Intensive care medicine experimental, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Pedro Vitale MendesMedical Intensive Care Unit, Hospital das Clinicas HCFMUSP, University of São Paulo School of Medicine, São Paulo, SP, Brazil. p.mendes@hc.fm.usp.br.ORCID http://orcid.org/0000-0002-6062-9105
Marcelo ParkMedical Intensive Care Unit, Hospital das Clinicas HCFMUSP, University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Luciano Cesar Pontes de AzevedoMedical Intensive Care Unit, Hospital das Clinicas HCFMUSP, University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Caio Cesar Araujo MoraisAnesthesia, Critical Care and Pain, University of Harvard, Boston, MA, USA.
Marcelo Brito Passos AmatoPulmonary Division, Instituto do Coracao (Incor), University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Eduardo Leite Vieira CostaPulmonary Division, Instituto do Coracao (Incor), University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRUniversidade de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVeno-venous extracorporeal membrane oxygenation (ECMO) provides blood oxygenation and carbon dioxide removal in acute respiratory distress syndrome. However, during ECMO support, the native lungs still play an important role in gas exchange, functioning as a second oxygenator in series with ECMO. The hypoxic vasoconstriction mechanism diverts regional blood flow within the lungs away from regions with low oxygen levels, optimizing ventilation/perfusion matching. ECMO support has the potential to reduce this adaptive pulmonary response and worsen the ventilation/perfusion mismatch by raising venous oxygen partial pressure. Thus, the objective of this study was to evaluate the effect of ECMO on regional pulmonary perfusion and pulmonary hemodynamics during unilateral ventilation and posterior lung collapse.

methodsFive Agroceres pigs were instrumented, monitored and submitted to ECMO. We used the Electrical Impedance Tomography (EIT) to evaluate lung ventilation and perfusion in all protocol steps. Effects of ECMO support on pulmonary hemodynamics and perfusion involving two different scenarios of ventilation/perfusion mismatch: (1) right-lung selective intubation inducing collapse of the normal left lung and (2) dorsal lung collapse after repeated lung lavage. Data including hemodynamics, respiratory, lung perfusion/ventilation, and laboratory data over time were analyzed with a mixed generalized model using the subjects as a random factor.

resultsThe initiation of ECMO support provided a significant reduction in Mean Pulmonary Artery Pressure (PAPm) in both situations of ventilation/perfusion mismatch. However, distribution of lung perfusion did not change with the use of ECMO support.

conclusionsWe found that the use of ECMO support with consequent increase in venous oxygen pressure induced a significant drop in PAPm with no detectable effect on regional lung perfusion in different scenarios of ventilation/perfusion mismatch.

Indexed as

Acute lung injuryAcute respiratory distress syndromeElectrical impedanceExtracorporeal circulationPerfusionVentilation–perfusion ratio

Identifiers

PMID35467225
PMCPMC9038965
OpenAlexW4224317053

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.