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Date Published: 31/07/2024
Abstract Views: 71
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DOI: https://doi.org/10.47972/vjcts.v47i.1152
Issue
Vol. 47
Section
Research Article
How to Cite
Hideshi, I., Shingo, I., Hideaki, O., Midori, F., Shigeyuki, O., Teruyuki, K., Nguyen, T. B., & Le, N. T. (2024). Pulsatile Right Ventricle to Pulmonary Artery Extracorporeal Membrane Oxygenation in a Pigs. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 47, 5-16. https://doi.org/10.47972/vjcts.v47i.1152

Pulsatile Right Ventricle to Pulmonary Artery Extracorporeal Membrane Oxygenation in a Pigs

ITOH Hideshi1,2,3,, Ichiba Shingo4, Obata Hideaki5, Futami Midori6, Okahara Shigeyuki6, Kawabata Teruyuki5, The Binh Nguyen3,7, Ngoc Thanh Le3
1 1Nippon Bunri University Graduate School of Engineering
2 Department of Intensive Care Medicine and Clinical Engineering
3 University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet-Nam
4 Department of Intensive Care Medicine and Clinical Engineering, Tokyo Women’s Medical University Hospital, Tokyo, Japan
5 Department of Biomedical Engineering, Okayama University of Science, Okayama, Japan
6 Department of Medical Engineering, Junshin Gakuen University, Fukuoka, Japan
7 Cardiovascular Center, E Hospital, Hanoi, Viet-Nam

Main Article Content

Abstract

Background: We investigated the impact of right ventricle to pulmonary artery extracorporeal membrane oxygenation in acute respiratory dysfunction with or without pulsatile flow.                                                     


Methods: We used bronchoalveolar lavage with intrapulmonary administration of warm saline to establish a severe acute respiratory distress syndrome model (ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration ratio <200) in eight piglets (mean body weight: 8.45±1.24 kg). The piglets were categorized into the pulsatile (N=4) and non-pulsatile extracorporeal membrane oxygenation groups (N=4). We started right ventricle to pulmonary artery extracorporeal membrane oxygenation with a 60 mL/kg/min flow to support the animals for 6 hours. We monitored hemodynamic data and blood gas levels for assessing base excess, and performed arterial blood sampling and electrocardiogram. Interleukin-6 and endotherlin-1 concentrations in blood plasma were evaluated before and after right ventricle to pulmonary artery extracorporeal membrane oxygenation. We compared the lung wet/dry weight ratio as a measure of pulmonary edema and collected lung tissue samples for the pathologically evaluating pneumocytes before and after right ventricle to pulmonary artery extracorporeal membrane oxygenation.                                          


Results: We maintained stable hemodynamics and extracorporeal membrane oxygenation flow above an arterial oxygen saturation of 85% in both groups. Pneumocyte evaluation showed clearly less pulmonary edema, pulmonary fibrosis, and inflammation. Interleukin-6 concentration was less in the pulsatile group than in the non-pulsatile group.                                           


Conclusions: Pulsatile right ventricle to pulmonary artery extracorporeal membrane oxygenation was less vasoconstrictive and maintained more effective oxygenated pulmonary flow. It ameliorates pulmonary circulation and facilitates recovery from acute respiratory failure.

Article Details

Keywords

Extracorporeal Membrane Oxygenation (ECMO), Acute Respiratory Distress Syndrome (ARDS), Right Ventricle to Pulmonary Artery (RV-PA), Pulsatile, Non-pulsatile

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