Respiratory failure & ventilation
Pulmonary pulsatility quantified by electrical impedance tomography in severe acute respiratory distress syndrome patients undergoing extracorporeal membrane oxygenation support
Authors' conclusion
n severe ARDS patients on ECMO, pulsatility amplitude reflects stroke volume changes induced by positive intrathoracic pressures and mixed venous saturation targets. However, downstream flow obstruction appears to be the leading determinant in the dorsal lung and may be useful to monitor right heart loading in patients with ARDS.
Study context
- Population
- Severe acute respiratory distress syndrome (ARDS) patients on veno-venous extracorporeal membrane oxygenation (ECMO), protective ventilation16/20 analysable electrical impedance tomography (EIT)
- Participants
- 20 patients
- Comparison
- ECMO blood flow adjusted to 3 SvO2 target ranges
- Primary endpoint
- Relationship between regional EIT pulsatility and pulmonary hemodynamics
- Follow-up
- 30 min after adjusting ECMO blood flow
Methodological detailsphysiological study, reanalysis, randomised order of ECMO blood flow steps, mixed-effects modelling, EIT units calibrated to millilitres of tidal volume (ml*), PEEP 15[12-16] cmH2O, Vt 4 ± 1 ml/kg PBW
- Physiological study
- Reanalysis
- Randomised order of ECMO blood flow steps
- Mixed-effects modelling
- EIT units calibrated to millilitres of tidal volume (ml*)
- PEEP 15[12-16] cmH2O, Vt 4 ± 1 ml/kg PBW
Primary result
As reported in the abstract
Pulsatility amplitude vs hemodynamics (across blood flow steps)
- Pulsatility amplitude directly related to stroke volume (SV), β (ml*/mL), p = 0.014
- 0.28 (0.06 - 0.5)
- Pulsatility amplitude directly related to pulmonary artery pressure (PAPs), β (ml*/mmHg), p = 0.008
- 0.47 (0.14 - 0.81)
- Pulsatility amplitude inversely related to PvO2, β (ml*/mmHg), p = 0.039
- −0.41 (−0.79--0.03)
- Concordance rate of pulsatility changes with SV changes
- 80%
- Concordance rate of pulsatility changes with PAPs changes
- 83%
Further findings
| Outcome | Low SvO2 | Intermediate SvO2 | High SvO2 |
|---|---|---|---|
| Correlation of dorsal pulsatility with pulmonary artery pressureModerate to strong correlations | |||
| ρ | 0.72 | 0.59 | 0.81 |
| p | p = 0.001 | p = 0.017 | p < 0.001 |
Ventral lung pulsatility during inspiration
- Decrease in ventral lung pulsatility during inspiration at each ECMO blood flow step (p < 0.01 for all steps)
Original publication
Pulmonary pulsatility quantified by electrical impedance tomography in severe acute respiratory distress syndrome patients undergoing extracorporeal membrane oxygenation support. Ann Intensive Care. Published 28 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →