Optimization of extracorporeal membrane oxygenation therapy using near-infrared spectroscopy to assess changes in peripheral circulation: A pilot study.
Hsiao-Huang ChangYi-Chih ChenChun-Jung HuangChia-Cheng KuoYi-Min WangChia-Wei SunPublished in: Journal of biophotonics (2020)
Near-infrared spectroscopy (NIRS) has been proposed as a noninvasive modality for detecting complications in patients undergoing extracorporeal membrane oxygenation (ECMO), and it can simultaneously reveal the global circulatory status of these patients. We optimized ECMO therapy on the basis of real-time peripheral NIRS probing. Three patients underwent venoarterial (VA) ECMO and one patient underwent venovenous (VV) ECMO. All patients received peripheral ECMO cannulation with routine distal perfusion catheter placement. We designed an experimental protocol to adjust ECMO blood flow over 1 hour. Hemodynamic responses were measured using NIRS devices attached to the calf at approximately 60% of the distance from the ankle to the knee. HbO2 levels change substantially with adjustments in ECMO flow, and they are more sensitive than HHb levels and the tissue saturation index (TSI) are. NIRS for optimizing ECMO therapy may be reliable for monitoring global circulatory status.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- respiratory failure
- end stage renal disease
- newly diagnosed
- patients undergoing
- chronic kidney disease
- ejection fraction
- mechanical ventilation
- blood pressure
- prognostic factors
- magnetic resonance imaging
- randomized controlled trial
- intensive care unit
- gene expression
- total knee arthroplasty
- patient reported outcomes
- dna methylation
- minimally invasive
- magnetic resonance
- smoking cessation