The Impact of Recirculation on Extracorporeal Gas Exchange and Patient Oxygenation during Veno-Venous Extracorporeal Membrane Oxygenation—Results of an Observational Clinical Trial Article Swipe
Johannes Gehron
,
Dirk Bandorski
,
Konstantin Mayer
,
Andreas Böning
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/jcm12020416
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/jcm12020416
Background: Recirculation during veno-venous extracorporeal membrane oxygenation reduces extracorporeal oxygen exchange and patient oxygenation. To minimize recirculation and maximize oxygen delivery (DO2) the interaction of cannulation, ECMO flow and cardiac output requires careful consideration. We investigated this interaction in an observational trial. Methods: In 19 patients with acute respiratory distress syndrome and ECMO, we measured recirculation with the ultrasound dilution technique and calculated extracorporeal oxygen transfer (VO2), extracorporeal oxygen delivery (DO2) and patient oxygenation. To assess the impact of cardiac output (CO), we included CO measurement through pulse contour analysis. Results: In all patients, there was a median recirculation rate of approximately 14–16%, with a maximum rate of 58%. Recirculation rates >35% occurred in 13–14% of all cases. In contrast to decreasing extracorporeal gas exchange with increasing ECMO flow and recirculation, patient oxygenation increased with greater ECMO flows. High CO diminished recirculation by between 5–20%. Conclusions: Extracorporeal gas exchange masks the importance of DO2 and its effects on patients. We assume that increasing DO2 is more important than reduced VO2. A negative correlation of recirculation to CO adds to the complexity of this phenomenon. Patient oxygenation may be optimized with the direct measurement of recirculation.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/jcm12020416
- https://www.mdpi.com/2077-0383/12/2/416/pdf?version=1673594459
- OA Status
- gold
- Cited By
- 15
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4313559908
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4313559908Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/jcm12020416Digital Object Identifier
- Title
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The Impact of Recirculation on Extracorporeal Gas Exchange and Patient Oxygenation during Veno-Venous Extracorporeal Membrane Oxygenation—Results of an Observational Clinical TrialWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-01-04Full publication date if available
- Authors
-
Johannes Gehron, Dirk Bandorski, Konstantin Mayer, Andreas BöningList of authors in order
- Landing page
-
https://doi.org/10.3390/jcm12020416Publisher landing page
- PDF URL
-
https://www.mdpi.com/2077-0383/12/2/416/pdf?version=1673594459Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
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https://www.mdpi.com/2077-0383/12/2/416/pdf?version=1673594459Direct OA link when available
- Concepts
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Medicine, Extracorporeal membrane oxygenation, Observational study, Oxygenation, Anesthesia, Intensive care medicine, Internal medicineTop concepts (fields/topics) attached by OpenAlex
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15Total citation count in OpenAlex
- Citations by year (recent)
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2025: 7, 2024: 7, 2023: 1Per-year citation counts (last 5 years)
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35Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W6600584668, https://openalex.org/W14331486, https://openalex.org/W3123916451, https://openalex.org/W2085861414, https://openalex.org/W2411462076, https://openalex.org/W2412209527, https://openalex.org/W2401964242, https://openalex.org/W2116527420, https://openalex.org/W2020170009, https://openalex.org/W2017017658, https://openalex.org/W8275751, https://openalex.org/W6713168419, https://openalex.org/W2042743730, https://openalex.org/W2017240644, https://openalex.org/W2079100812, https://openalex.org/W2087996114, https://openalex.org/W2468579535, https://openalex.org/W2169732472, https://openalex.org/W2556501320, https://openalex.org/W1979469936, https://openalex.org/W2048431759, https://openalex.org/W3160191138, https://openalex.org/W2055167071, https://openalex.org/W2001027283, https://openalex.org/W4256419019, https://openalex.org/W2048217853, https://openalex.org/W2015427091, https://openalex.org/W3216518979, https://openalex.org/W3108403526, https://openalex.org/W2108712092, https://openalex.org/W2986436062, https://openalex.org/W4225403237, https://openalex.org/W4229072603, https://openalex.org/W2077738081, https://openalex.org/W2405962501 |
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| abstract_inverted_index.A | 170 |
| abstract_inverted_index.a | 96, 104 |
| abstract_inverted_index.19 | 44 |
| abstract_inverted_index.CO | 84, 139, 176 |
| abstract_inverted_index.In | 43, 91, 118 |
| abstract_inverted_index.To | 14, 74 |
| abstract_inverted_index.We | 34, 159 |
| abstract_inverted_index.an | 39 |
| abstract_inverted_index.be | 187 |
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| abstract_inverted_index.its | 155 |
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| abstract_inverted_index.the | 22, 57, 76, 150, 179, 190 |
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| abstract_inverted_index.58%. | 108 |
| abstract_inverted_index.ECMO | 26, 127, 136 |
| abstract_inverted_index.High | 138 |
| abstract_inverted_index.VO2. | 169 |
| abstract_inverted_index.adds | 177 |
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| abstract_inverted_index.(DO2) | 21, 70 |
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| abstract_inverted_index.median | 97 |
| abstract_inverted_index.output | 30, 80 |
| abstract_inverted_index.oxygen | 9, 19, 64, 68 |
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| abstract_inverted_index.important | 166 |
| abstract_inverted_index.increased | 133 |
| abstract_inverted_index.optimized | 188 |
| abstract_inverted_index.patients, | 93 |
| abstract_inverted_index.patients. | 158 |
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| abstract_inverted_index.phenomenon. | 183 |
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| abstract_inverted_index.consideration. | 33 |
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| abstract_inverted_index.recirculation, | 130 |
| abstract_inverted_index.recirculation. | 194 |
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| corresponding_author_ids | https://openalex.org/A5022895775 |
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| institutions_distinct_count | 4 |
| corresponding_institution_ids | https://openalex.org/I268975460 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/6 |
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| sustainable_development_goals[0].display_name | Clean water and sanitation |
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| citation_normalized_percentile.is_in_top_10_percent | False |