Renal hemodynamics by return cannular position of extracorporeal membrane oxygenation in swine

Hee Jung Kim, Seong Cheol Jeong, Jae Seung Jung, In Seup Kim, Choon Hak Lim, Ho Sung Son

    Research output: Contribution to journalArticlepeer-review

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)4211-4217
    Number of pages7
    JournalJournal of Thoracic Disease
    Volume11
    Issue number10
    DOIs
    Publication statusPublished - 2019

    Keywords

    • Acute kidney injury (AKI)
    • Aorta
    • Arterial pressure
    • Extracorporeal membrane oxygenation (ECMO)
    • Femoral artery

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine

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