Assessment of Right Heart Function during Extracorporeal Therapy by Modified Thermodilution in a Porcine Model

ConclusionsAdapted thermodilution allows reliable assessment of cardiac output and right ventricular behavior. During veno-arterial extracorporeal membrane oxygenation weaning, the right ventricle dilates even with stable function, possibly because of increased venous return.Editor ’s PerspectiveWhat We Already Know about This TopicVeno-arterial extracorporeal membrane oxygenation is an accepted rescue therapy for patients experiencing severe cardiac or pulmonary failure.Weaning from veno-arterial extracorporeal membrane oxygenation is important for determining next steps in patients ’ cardiopulmonary care. Assessment of right ventricular function during veno-arterial extracorporeal membrane oxygenation support and weaning is often done using echocardiography, but echocardiographic guidance provides challenges because right ventricular dimensions change with ventricular loadin g and may not be related to intrinsic right ventricular function.What This Article Tells Us That Is NewIn 16 healthy pigs that received veno-arterial extracorporeal membrane oxygenation supportvia central cannulation, a novel adaptation of thermodilution cardiac output assessment provided reliable estimation of right ventricular cardiac output and right ventricular function.Future studies appear warranted to determine whether this method of modified thermodilution can be used to accurately assess right ventricular output and function during veno-arterial extracorporeal membrane oxygenation support.

Source: Anesthesiology - July 8, 2020 Category: Anesthesiology Source Type: research