Table II.
Respiratory and hemodynamic parameters during ICU stay and ECMO
| 1 h before ECMO |
12 h after ECMO initiation |
On ECMO Day 2 |
Pre-ECMO weaning |
48 h after ECLS explanation |
|
|---|---|---|---|---|---|
| Hemodynamic values | |||||
| Cardiac output (L/min)/cardiac index (L/min·m2) |
3.11/1.8 | 3.80/2.2 | 5.88/3.4 | 6.57/3.8 | – |
| MAP (mmHg) | 40 | 80 | 82 | 95 | 80 |
| Mechanical ventilation setting | |||||
| Modality | CV | BiPAP | BiPAP | BiPAP | CPAP |
| FiO2 | 100% | 40% | 30% | 50% | 40% |
| PIP (cmH2O) | 45 | 24 | 25 | 20 | 16 |
| PEEP (cmH2O) | 15 | 12 | 10 | 12 | 8 |
| Tidal volume (mL) | 350 | 75 | 200 | 720 | 670 |
| Breaths/min | 16 | 7 | 8 | 9 | 14 |
| Pulmonary compliance (mL/cm2) | 18.7 | 16.8 | 20.6 | 64.5 | – |
| Oxygenation index | 92.8 | ||||
| Murray score | 4 | – | – | – | – |
| ECMO setting | |||||
| ECMO flow (L/min and L/min·m2) | – | 5/2.89 | 5.5/3.17 | 3.5/2.02 | – |
| ECMO gas flow (L/min) | – | 5 | 4 | – | |
| ECMO FiO2 (%) | – | 100 | 100 | 100 | – |
| Laboratory values | |||||
| WBC count (N·1000/mL) | 23.8 | 18.4 | 6.9 | 6.2 | 6.7 |
| Hb (g/dL) | 11.8 | 9.5 | 11.2 | 11.9 | 11.3 |
| Platelet count (N·1000/mL) | 109 | 92 | 62 | 91 | 163 |
| Procalcitonin (ng/mL) | 250.12 | 190.25 | 96.63 | 8.65 | 2.97 |
| Serum creatinine (mg/dL) | 2.5 | 1.68 | 1.11 | 0.76 | 0.62 |
| Blood gas values/organ perfusion | |||||
| Radial artery blood samples | |||||
| pH | 7.05 | 7.48 | 7.47 | 7.49 | 7.46 |
| pCO2 (mmHg) | 96 | 41.4 | 38 | 35.6 | 37.8 |
| pO2 (mmHg) | 48.5 | 126 | 96.4 | 111 | 98.7 |
| sO2 (%) | 83 | 99.7 | 99.3 | 99.5 | 99.9 |
| Lac (mmol/L) | 6.7 | 2.9 | 1.4 | 1.5 | 1.1 |
| BE (mml/L) | –12 | 1.7 | 3.5 | 2.2 | 1.3 |
| HCO3 (mml/L) | 29 | 26.3 | 27.6 | 25.8 | 26.7 |
| Pulmonary artery blood samples | |||||
| pCO2 (mmHg) | – | 42.4 | 42.6 | 43.8 | – |
| pO2 (mmHg) | – | 78.6 | 88.8 | 89.2 | – |
| sO2 (%) | – | 94.5 | 97.4 | 95.1 | – |
| Central venous samples | |||||
| pCO2 (mmHg) | – | 51.3 | 52.5 | 53.6 | |
| pO2 (mmHg) | – | 43.5 | 44.7 | 45.3 | |
| ScvO2 (%) | – | 66.5 | 74.6 | 73.8 | |
| Pre-oxygenator samples | |||||
| pCO2 (mmHg) | – | 50.6 | 51.4 | 55.2 | – |
| pO2 (mmHg) | – | 46.5 | 48.8 | 46.5 | – |
| sO2 (%) | – | 66.5 | 74.6 | 74.4 | – |
| Post-oxygenator samples | |||||
| pCO2 (mmHg) | – | 31.2 | 32.6 | – | |
| pO2 (mmHg) | – | 412.6 | 424 | – | |
| sO2 (%) | – | 100 | 100 | 100 | – |
| BRF (%) (preoxy
sO2–ScO2)/ (postoxy sO2–ScO2)·100 |
– | 5.54 | 5.07 | 1.95 | – |
| Patients BSA = 1.73 m2. All reported data are the mean of 3 consecutive measures.Abbreviations: CV = controlled volume; BiPAP = bi-levels positive airways pressure; CPAP = continuous positive airways pressure; FiO2 = fraction inspired oxygen; MV = respiratory minute volume; TV = tidal volume; PEEP = positive end-expiratory pressure; PIP = peak inspiratory pressure; CO = cardiac output; BSA = body surface area; CI = cardiac index; ECMO = extracorporeal membrane oxygenation; paCO2 = arterial carbon dioxide tension; paO2 = arterial oxygen tension; WBC = white blood cells; Hb = hemoglobin concentration; SO2 = oxygen saturation; ctO2 = oxygen content; Lac = lactate concentration; ABE = base excess; HCO3= bicarbonate concentration; ScvO2 = central-venous oxygen saturation; BRF = blood recirculation fraction with calculation formula [8] | |||||