Table 1.
Before ECMO | +ECMO only | On ECMO first day | ||||
---|---|---|---|---|---|---|
Patient | Simulation | Simulation | Patient | Simulation | ||
Heart rate | /min | 137 | 137 | 137 | 133 | 133 |
Mean arterial pressure | mmHg | 85 | 85 | 106 | 98 | 98 |
Right ventricular systolic pressure | mmHg | 49 | 49 | 46 | NA | 47 |
Central venous pressure | mmHg | 10 | 10 | 9 | 8 | 9 |
Left Ventricular end‐diastolic volume | mL | 84.6 | 84.7 | 93.3 | 101.1 | 93.7 |
Left ventricular end‐diastolic pressure | mmHg | NA | 19 | 23 | NA | 23 |
Ejection fraction | % | 27.6 | 27.8 | 19.5 | 30.9 | 23.4 |
Tricuspid regurgitation velocity | cm/s | 311 | 315 | 310 | NA | NA |
ECMO flow | L/min | 0 | 0 | 2.1 | 2.1 | 2.1 |
The middle column +ECMO only shows effects of solely increasing peripheral ECMO flow from 0 to 2.1 L/min. Simulated data concerning the first day on VA ECMO are adjusted according to clinical data (HR identical, SVR and PVR decreased proportionally to achieve identical MAP, TR removed). Simulation supports the experimental findings of increased LV loading with VA-ECMO. The larger LV and EF in the patient on the first day of VA ECMO is compatible with fluid loading and partial recovery of LV function in addition to the effects of VA-ECMO as supported by clinical data
HR heart rate, SVR systemic vascular resistance, PVR pulmonary vascular resistance, MAP mean arterial pressure, TR tricuspid regurgitation, LV left ventricle and EF ejection fraction, NA data are not available