https://scholars.lib.ntu.edu.tw/handle/123456789/634139
DC 欄位 | 值 | 語言 |
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dc.contributor.author | Wei, Tzu-Jung | en_US |
dc.contributor.author | CHIH-HSIEN WANG | en_US |
dc.contributor.author | Chan, Wing-Sum | en_US |
dc.contributor.author | Yeh, Yi-Chun | en_US |
dc.contributor.author | Lai, Chien-Heng | en_US |
dc.contributor.author | Chao, Anne | en_US |
dc.contributor.author | Huang, Chi-Hsiang | en_US |
dc.contributor.author | Wang, Ming-Jiuh | en_US |
dc.contributor.author | Cheng, Ya-Jung | en_US |
dc.contributor.author | YIH-SHARNG CHEN | en_US |
dc.contributor.author | Ince, Can | en_US |
dc.contributor.author | Lin, Tzu-Yu | en_US |
dc.contributor.author | Yeh, Yu-Chang | en_US |
dc.date.accessioned | 2023-07-25T01:17:40Z | - |
dc.date.available | 2023-07-25T01:17:40Z | - |
dc.date.issued | 2020-02-07 | - |
dc.identifier.uri | https://scholars.lib.ntu.edu.tw/handle/123456789/634139 | - |
dc.description.abstract | Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) pump flow is crucial for maintaining tissue and organ perfusion in patients with cardiogenic shock. Determining the optimal VA-ECMO pump flow rate to maintain adequate tissue perfusion remains a clinical challenge. Poor microcirculation is associated with higher mortality in patients using VA-ECMO. Change in VA-ECMO pump flow is expected to result in a coherent change in microcirculatory blood flow, but this has not been investigated. This study investigated the effect of altering VA-ECMO pump flow rate on sublingual microcirculation. Methods: Sublingual microcirculation images were recorded using an incident dark-field hand held vital microscope at two time points, within 24 h (T1) and at 24-48 h (T2) after VA-ECMO placement. Microcirculation was measured before and 5 minutes after the changes in VA-ECMO pump flow rate at each time point. Events of changing VA-ECMO pump flow rate at T1 and T2 were divided into four groups according to changes in perfused vessel density (PVD): Group A, increased pump flow rate and increased or sustained PVD; Group B, increased pump flow rate and decreased PVD; Group C, decreased pump flow rate and increased or sustained PVD; and Group D, decreased pump flow rate and decreased PVD. The microcirculatory parameters, clinical parameters, and prognosis of each subgroup were recorded. Clinical parameters on 14-day and 28-day survivors and non-survivors were also compared. Results: A total of 25 patients were enrolled, and 38 events with good-quality images at T1 and T2 were categorized. Opposing response of microcirculation was observed in 43.5% of events when VA-ECMO pump flow rate was increased. Microcirculation was decreased in 33.4% of events when VA-ECMO pump flow rate was reduced. No predictive values in microcirculatory or macrocirculatory parameters before changing VA-ECMO pump flow rate were identified. Conclusions: Changes in VA-ECMO pump flow rate may have opposing effects on sublingual microcirculatory functional capillary density. We suggest that tandem measurements of microcirculation before and after altering the VA-ECMO pump flow may help to ensure optimal tissue perfusion. © 2020, CC BY. | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | ResearchSquare | en_US |
dc.subject | Cardiogenic shock | en_US |
dc.subject | Extracorporeal membrane oxygenation | en_US |
dc.subject | Microcirculation | en_US |
dc.title | Contradictory responses of the microcirculation to changes in extracorporeal membrane oxygenation pump flow in patients on venoarterial extracorporeal membrane oxygenation: a prospective observational study | en_US |
dc.type | other | en_US |
dc.identifier.doi | 10.21203/rs.2.22931/v1 | - |
dc.identifier.scopus | 2-s2.0-85133855931 | - |
item.languageiso639-1 | en | - |
item.openairetype | other | - |
item.fulltext | no fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_1843 | - |
item.grantfulltext | none | - |
item.cerifentitytype | Products | - |
crisitem.author.dept | Surgery-NTUH | - |
crisitem.author.dept | Surgery | - |
crisitem.author.dept | Surgery-NTUH | - |
crisitem.author.dept | Surgery | - |
crisitem.author.orcid | 0000-0003-3214-6867 | - |
crisitem.author.orcid | 0000-0003-3846-8162 | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
顯示於: | 醫學系 |
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