TY - JOUR
T1 - Renal hemodynamics by return cannular position of extracorporeal membrane oxygenation in swine
AU - Kim, Hee Jung
AU - Jeong, Seong Cheol
AU - Jung, Jae Seung
AU - Kim, In Seup
AU - Lim, Choon Hak
AU - Son, Ho Sung
N1 - Funding Information:
This work was supported by a Korea University Grant.
Publisher Copyright:
© 2019 Journal of Thoracic Disease.
PY - 2019
Y1 - 2019
N2 - Background: Whether arterial return cannula position affects the kidney during Veno-Arterial extracorporeal membrane oxygenation (ECMO) is unclear. Therefore, we compared hemodynamic parameters and acute kidney injury (AKI) biomarkers between ascending aorta return (aECMO) and femoral artery return ECMO (fECMO) in swine to evaluate the effect of cannula position on the kidney. Methods: A total of twelve swines were allocated randomly into two groups. ECMO was maintained for 6h. Hemodynamic parameters including mean arterial pressure (MAP), renal arterial flow rate (AF), energy equivalent pressure (EEP), and surplus hemodynamic energy (SHE) were measured at the left renal artery. For evaluation of kidney injury, samples were obtained for blood urea nitrogen, creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin (before ECMO, and 1, 3, and 6 h after initiating ECMO). Results: Before the start of ECMO, hemodynamic parameters were not different between the two groups. With regard to the rate of change before and after ECMO, the fECMO group showed a significantly higher increase in MAP, AF, and EEP and a greater decrease in SHE than the aECMO group (P<0.001). In inter-group analysis, no significant difference in time-dependent trends were observed for biochemical laboratory levels. Conclusions: FECMO support was associated with a higher energy profile at the renal artery than that with aECMO, whereas pulsatility was decreased.
AB - Background: Whether arterial return cannula position affects the kidney during Veno-Arterial extracorporeal membrane oxygenation (ECMO) is unclear. Therefore, we compared hemodynamic parameters and acute kidney injury (AKI) biomarkers between ascending aorta return (aECMO) and femoral artery return ECMO (fECMO) in swine to evaluate the effect of cannula position on the kidney. Methods: A total of twelve swines were allocated randomly into two groups. ECMO was maintained for 6h. Hemodynamic parameters including mean arterial pressure (MAP), renal arterial flow rate (AF), energy equivalent pressure (EEP), and surplus hemodynamic energy (SHE) were measured at the left renal artery. For evaluation of kidney injury, samples were obtained for blood urea nitrogen, creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin (before ECMO, and 1, 3, and 6 h after initiating ECMO). Results: Before the start of ECMO, hemodynamic parameters were not different between the two groups. With regard to the rate of change before and after ECMO, the fECMO group showed a significantly higher increase in MAP, AF, and EEP and a greater decrease in SHE than the aECMO group (P<0.001). In inter-group analysis, no significant difference in time-dependent trends were observed for biochemical laboratory levels. Conclusions: FECMO support was associated with a higher energy profile at the renal artery than that with aECMO, whereas pulsatility was decreased.
KW - Acute kidney injury (AKI)
KW - Aorta
KW - Arterial pressure
KW - Extracorporeal membrane oxygenation (ECMO)
KW - Femoral artery
UR - http://www.scopus.com/inward/record.url?scp=85076501075&partnerID=8YFLogxK
U2 - 10.21037/jtd.2019.09.73
DO - 10.21037/jtd.2019.09.73
M3 - Article
AN - SCOPUS:85076501075
SN - 2072-1439
VL - 11
SP - 4211
EP - 4217
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 10
ER -