ArticleCardiovascular engineering and technology2024
Investigations of Differential Hypoxemia During Venoarterial Membrane Oxygenation with and Without Impella Support.
Article in Cardiovascular engineering and technology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Harlequin Syndrome in Venoarterial ECMO and ECPELLA: When ECMO and Native or Impella Circulations Collide - A Comprehensive Review.Reviews in cardiovascular medicine · 2025Review
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeVenoarterial extracorporeal membrane oxygenation (VA ECMO) is used in patients with refractory cardiac or cardio-pulmonary failure. Native ventricular output interacts with VA ECMO flow and may hinder sufficient oxygenation to the heart and the brain. Further on, VA ECMO leads to afterload increase requiring ventricular unloading. The aim of the study was to investigate aortic blood flow and oxygenation for various ECMO settings and cannula positions with a numerical model.
methodsFour different aortic cannula tip positions (ascending aorta, descending aorta, abdominal aorta, and iliac artery) were included in a model of a human aorta. Three degrees of cardiac dysfunction and VA ECMO support (50%, 75% and 90%) with a total blood flow of 6 l/min were investigated. Additionally, the Impella CP device was implemented under 50% support condition. Blood oxygen saturation at the aortic branches and the pressure acting on the aortic valve were calculated.
resultsA more proximal tip orientation is necessary to increase oxygen supply to the supra-aortic and coronary arteries for 50% and 75% support. During the 90% support scenario, proper oxygenation can be achieved independently of tip position. The use of Impella reduces afterload by 8-17 mmHg and vessel oxygenation is similar to 50% VA ECMO support. Pressure load on the aortic valve increases with more proximal tip position and is decreased during Impella use.
conclusionsWe present a simulation model for the investigation of hemodynamics and blood oxygenation with various mechanical circulatory support systems. Our results underline the intricate and patient-specific relationship between extracorporeal support, cannula tip orientation and oxygenation capacity.
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