Evidence map›Paper›PMID 36459331›Full record

ArticlePhysical and engineering sciences in medicine2023

The effect of arterial cannula tip position on differential hypoxemia during venoarterial extracorporeal membrane oxygenation.

Avishka Wickramarachchi, Aidan J C Burrell, Andrew F Stephens, Michael Šeman, Ashkan Vatani, Mehrdad Khamooshi, Jaishankar Raman, Rinaldo Bellomo, Shaun D Gregory

Abstract read
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In one paragraph

Article in Physical and engineering sciences in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 30% 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

4 citing papers in PubMed, 13 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

9 authors at 4 institutions in 1 country.

Avishka WickramarachchiCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia. avishka.wickramarachchi@monash.edu.ORCID http://orcid.org/0000-0003-2623-7009
Aidan J C BurrellIntensive Care Unit, Alfred Hospital, Melbourne, Australia.
Andrew F StephensCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Michael ŠemanCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Ashkan VataniCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Mehrdad KhamooshiCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Jaishankar RamanCardiothoracic Surgery, Austin & St Vincent's Hospitals, University of Melbourne, Melbourne, Australia.
Rinaldo BellomoAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Shaun D GregoryCardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Baker Heart and Diabetes Institute · AUThe Alfred Hospital · AUThe Royal Melbourne Hospital · AUThe University of Melbourne · AU

Funding

National Heart Foundation of Australia 102062
6 · The paper itself

Abstract

Interaction between native ventricular output and venoarterial extracorporeal membrane oxygenation (VA ECMO) flow may hinder oxygenated blood flow to the aortic arch branches, resulting in differential hypoxemia. Typically, the arterial cannula tip is placed in the iliac artery or abdominal aorta. However, the hemodynamics of a more proximal arterial cannula tip have not been studied before. This study investigated the effect of arterial cannula tip position on VA ECMO blood flow to the upper extremities using computational fluid dynamics simulations. Four arterial cannula tip positions (P1. common iliac, P2. abdominal aorta, P3. descending aorta and P4. aortic arch) were compared with different degrees of cardiac dysfunction and VA ECMO support (50%, 80% and 90% support). P4 was able to supply oxygenated blood to the arch vessels at all support levels, while P1 to P3 only supplied the arch vessels during the highest level (90%) of VA ECMO support. Even during the highest level of support, P1 to P3 could only provide oxygenated VA-ECMO flow at 0.11 L/min to the brachiocephalic artery, compared with 0.5 L/min at P4. This study suggests that cerebral perfusion of VA ECMO flow can be increased by advancing the arterial cannula tip towards the aortic arch.

Indexed as

Extracorporeal Membrane OxygenationAorta, ThoracicCannulaCatheterizationHumansHypoxiaCannula positionComputational fluid dynamicsHarlequin syndromeMixing zoneNorth–south syndromeWatershed region

Identifiers

PMID36459331
OpenAlexW4310592307

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.