Effects of Extracorporeal Membrane Oxygenation (ECMO) on Fetal Lambs

Aaurata, Yuji; Ibara, Satoshi; Quilligan, Edward J.; Oka, Satoshi; Endo, Chikara; Fujimori, Keiya; Kamimura, Toshiya

doi:10.3109/14767059509017303

Cited by 5 publications

(6 citation statements)

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“…An "artificial placenta" using ECMO has been developed since the 1960 [1,11,12,15]. Kuwahara et al have recently performed an umbilical artery to umbilical vein ECMO in goat fetus [9].…”

Section: Discussionmentioning

confidence: 99%

“…Either a 6F or 7F cannula was inserted into the left carotid artery until the tip of the cannula was 3-4 cm above the aortic valve fluoroscopically, and it was used to return blood to the dog Extracorporeal membrane oxygenation (ECMO) is frequently used for treatment of life-threatening respiratory failure. Several researchers have developed an "artificial placenta" using ECMO experimentally since the 1960 [1,9,11,12,15]. In small animal practices, ECMO is scarcely used in veterinary medicine.…”

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confidence: 99%

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Regional Blood Flow Distribution from the Proximal Arterial Cannula during Veno-Arterial Extracorporeal Membrane Oxygenation in Neonatal Dog.

Kamimura

Sakamoto

Misumi

1999

The Journal of Veterinary Medical Science

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ABSTRACT. Extracorporeal membrane oxygenation (ECMO) is frequently used for treatment of patients with severe hypoxemia due to lifethreatening respiratory failure. Due to this hypoxemia, the myocardium of these patients is insufficiently provided with oxygen, and consequently their cardiac function commonly deteriorates. But veno-arterial (V-A) ECMO provides oxygenated blood to the coronary arteries from ECMO circuit insufficiently. To increase the coronary blood flow distributed from ECMO, we placed the arterial cannula 1 cm above the aortic valve and evaluated the regional blood flow from the proximal arterial cannula in comparison with the distal cannula. Eight neonatal dogs weighting 1.8-2.5 kg were supported by V-A ECMO. The regional blood flow from the arterial cannula was measured by injection of colored microspheres into ECMO circuit. The site of the arterial cannula was changed under fluoroscopy. The bypass flow was maintained at either 50 or 100 ml/min/kg. We found that the coronary blood flow distributed from the proximal arterial cannula was significantly higher than that from the distal cannula. The proximal arterial cannula appears necessary to provide sufficient oxygenated blood to the coronary circulation during V-A ECMO. Therefore, it is expected that the increased cardiac function may improved, and that the survival rate of the patients with retarded cardiac function due to severe hypoxemia may increase by proximal placement of the arterial cannula during V-A ECMO. MATERIALS AND METHODSAnimal: Eight mongrel neonatal dogs within 1 month old were used in this study. Their body weight ranged between 1.8 to 2.5 kg. The animals were subjected to the experiment, after checking their fitness clinically by preoperative examination, including physical examination, clinical laboratory evaluation, and radiography of the thorax. The experiment was carried out in accordance with the Guide for Animal Experimentation, Faculty of Agriculture, Kagoshima University.Surgical procedure: The dogs fasted for 24 hr before surgery. The animals were anesthetized with 25 mg/kg of pentobarbital sodium intravenously, and intubated with a cuffed endotracheal tube, and ventilated mechanically throughout the experiment. The peak air pressure was set at 12 mmHg, and the respiratory rate was set between 8 and 15 times per minute. Topical 1% lidocain was used as necessary to dilate the vessel and to insert the cannula easily. An incision was made in the neck of each dog, and either a 6F or 7F cannula was inserted into the left jugular vein in a caudal direction until the tip of the cannula was placed in the right atrium. A 6F polyvinyl cannula was inserted into the left femoral vein in a cranial direction until the tip was placed in the vena cava. These two cannulae placed in the jugular and femoral vein were used for withdrawal blood during ECMO. These venous cannulae were connected to each other by a Y-shape connector. Either a 6F or 7F cannula was inserted into the left carotid artery until the tip of the cannula was 3-4 cm...

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“…An "artificial placenta" using ECMO has been developed since the 1960 [1,11,12,15]. Kuwahara et al have recently performed an umbilical artery to umbilical vein ECMO in goat fetus [9].…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Regional Blood Flow Distribution from the Proximal Arterial Cannula during Veno-Arterial Extracorporeal Membrane Oxygenation in Neonatal Dog.

Kamimura

Sakamoto

Misumi

1999

The Journal of Veterinary Medical Science

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“…V -A ECMO and V -V ECMO has a different site into which blood is returned, resulting in differences in their characteristics. Murata and coworkers reported the usefulness of fetal oxygenation by V -A ECMO when the mothers were kept under hypoxic conditions in the presence of fetalplacental circulation after preparing the chronic fetal sheep experiment model 3) . In V -A ECMO, blood is returned to the carotid artery skipping the heart, which might therefore be suitable as a circulating system that assists cardiac function in cases with lowered cardiac function.…”

Section: Discussionmentioning

confidence: 99%

“…There have been two reports by Murata and coworkers where they prepared chronic fetal sheep experiment models in which the mothers were kept under hypoxic conditions to institute veno -arterial (V -A) ECMO. Blood was obtained from the fetal right atrium and oxygenated blood was returned to the caudal carotid artery, contributing to the improvement in fetal oxygen concentrations 3,4) . Recently, a less invasive method of venovenous (V -V) ECMO, which is performed with one double lumen catheter placed into the right atrium via the right jugular vein to obtain and return blood, has been applied to newborn babies in clinical settings 5,6) .…”

Section: Introductionmentioning

confidence: 99%

The Endocrinological Responses of Veno-Venous Extracorporeal Membrane Oxygenation on Hypoxic Fetal Lambs

Nomura

Katô²,

Fujimori³

et al. 2012

FJMS

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:Objective : The purpose of this study was to observe endocrinological responses of venoarterial and veno -venous extracorporeal membrane oxygenation (V -A and V -V ECMO) to support fetal oxygenation in utero.Methods : An ECMO system with a centrifugal pump was applied to six chronically instrumented fetal lambs, at 126 -134 days of gestation. Blood was obtained through a double -lumen catheter inserted into the right atrium. After oxygenation, the blood was returned through a single -lumen catheter into either the carotid artery (veno -arterial ; V -A ECMO) or the right atrium (V -V ECMO). After fetal hypoxia had been experimentally produced, V -A ECMO or V -V ECMO was instituted to maintain fetal oxygenation. We compared fetal blood gases and concentrations of atrial natriuretic peptide (ANP), epinephrine and norepinephrine with both routes of ECMO.Results : Fetal carotid artery pH did not change during hypoxemia, but decreased after instituting V -A ECMO and V -V ECMO. After instituting V -A ECMO or V -V ECMO for 30 min, oxygen partial pressure (pO2) in the fetal cranial carotid artery recovered from the hypoxic level. The ANP concentration in V -V ECMO was significantly lower than that in V -A ECMO. Fetal serum epinephrine and norepinephrine concentrations significantly increased in association with hypoxic stimulation. There was a further increase in fetal serum epinephrine concentration after instituting V -A ECMO. No significant difference in concentration was found after instituting V -V ECMO from that of after the institution of V -A ECMO.Conclusions : This study suggested that V -V ECMO may possibly be less invasive than V -A ECMO for fetal heart, because ANP, a cardiac distress index, was lower in V -V ECMO than in V -A ECMO.

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“…We previously reported that veno-arterial (V-A) ECMO, maintained from the right atrium to the carotid artery, effectively oxygenated intrauterine fetal lambs and that normal fetal oxygenation was maintained by the ECMO system during maternal hypoxia produced by reducing maternal fraction inspiratory oxygen (FiO 2 ) 10 . V-A ECMO has been successful in support of fetal and neonatal oxygenation but requires ligation of one of the common carotid arteries.…”

Section: Introductionmentioning

confidence: 99%

The effects of veno-venous extracorporeal membrane oxygenation on hypoxic fetal lambs

Fujimori

Nomura

Katô

et al. 2004

Journal of Maternal-Fetal and Neonatal Medicine

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Effects of Extracorporeal Membrane Oxygenation (ECMO) on Fetal Lambs

Cited by 5 publications

References 3 publications

Regional Blood Flow Distribution from the Proximal Arterial Cannula during Veno-Arterial Extracorporeal Membrane Oxygenation in Neonatal Dog.

Regional Blood Flow Distribution from the Proximal Arterial Cannula during Veno-Arterial Extracorporeal Membrane Oxygenation in Neonatal Dog.

The Endocrinological Responses of Veno-Venous Extracorporeal Membrane Oxygenation on Hypoxic Fetal Lambs

The effects of veno-venous extracorporeal membrane oxygenation on hypoxic fetal lambs

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