Effects of changes in veno-venous extracorporeal membrane oxygenation blood flow on the measurement of intrathoracic blood volume and extravascular lung water index: a prospective interventional study
Authors' conclusion
In patients with severe ARDS managed with V-V ECMO, increasing ECBF alters the thermodilution curve, resulting in unreliable measurements of EVLWI and ITBVI.
Study context
- Population
- Patients with severe acute respiratory distress syndrome (ARDS) managed with V–V ECMOcrossover of extracorporeal blood flow (ECBF) rates
- Participants
- 20 patients
- Exposure
- ECBF 4 and 2 l/min vs 6 l/min during V-V ECMO
- Outcome
- EVLWI and ITBVI measured by transpulmonary thermodilution
Main finding
As reported in the abstract
| Group | Value | Intrathoracic blood volume index (ITBVI) |
|---|---|---|
| 6 l/min | 26.1 (IQR 22.8–33.8) ml/kg | 840 [753-1062] ml/m² |
| 4 l/min | 22.4 (IQR 15.3–31.6) ml/kg | 886 [658-979] ml/m² |
| 2 l/min | 13.2 (IQR 11.8–18.8) ml/kg | 955 [817-1140] ml/m² |
Value
6 l/min26.1 (IQR 22.8–33.8) ml/kg
4 l/min22.4 (IQR 15.3–31.6) ml/kg
2 l/min13.2 (IQR 11.8–18.8) ml/kg
Intrathoracic blood volume index (ITBVI)
6 l/min840 [753-1062] ml/m²
4 l/min886 [658-979] ml/m²
2 l/min955 [817-1140] ml/m²
- 4 l/min vs 6 l/min: P < 0.001
- 2 l/min vs 6 l/min: P < 0.001
- 4 l/min vs 6 l/min: P < 0.001
- 2 l/min vs 6 l/min: P < 0.001
Observational data: associations, not effects.
Original publication
Effects of changes in veno-venous extracorporeal membrane oxygenation blood flow on the measurement of intrathoracic blood volume and extravascular lung water index: a prospective interventional study. J Clin Monit Comput. Published 25 October 2022. doi:10.
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