Table 1.
Baseline characteristics and changes of safety variables from baseline to 6 h after contrast media application
| Baseline characteristics | |||||
| Male sex | 9 [90] | ||||
| Age (years) | 52 (50–55) | ||||
| Reason for ECMO | |||||
| Refractory cardiac arrest | 6 [60] | ||||
| Cardiogenic shock | 4 [40] | ||||
| Presence of severely impaired left ventricular systolic function | 10 [100] | ||||
| Time from ECMO start to study inclusion (days), min to max | 0–1 | ||||
| Successful ECMO weaning | 5 [50] | ||||
| Good neurologic outcome (CPC 1–2) | 3 [30] | ||||
| Post-oxygenator paO2 after contrast-enhanced ultrasound (mmHg) | 489 (439–507) | ||||
| Safety parameters | |||||
| Variable | Baseline (n = 10) | 5 min (n = 10) | 15 min (n = 10) | 2 h (n = 9) | 6 h (n = 8) |
| Ventilator FiO2 (%) | 48 (40–80) | 48 (40–80) | 48 (40–80) | 55 (45–80) | 48 (40–70) |
| Peak pressure (mbar) | 19.5 (18–21) | 19 (18–21) | 19 (18–21) | 20 (19–23) | 18 (18–23) |
| MAP (mmHg) | 73 (70–81) | 73 (64–93) | 73 (64–93) | 77 (73–82) | 82 (74–94) |
| Norepinephrine (μg/kg/min) | 0.34 (0.209–0.670) | 0.250 (0.148–0.480) | 0.250 (0.148–0.480) | 0.420 (0.190–0.620) | 0.410 (0.142–0.715) |
| Heart rate (bpm) | 97 (66–111) | 91 (64–107) | 90 (64–107) | 80 (61–105) | 95 (72–107) |
| Pump speed (rpm) | 2776 (2530–3151) | 2698 (2530–3000) | 2698 (2530–3000) | 2741 (2530–3000) | 3050 (2590–3300) |
| Blood flow (l/min) | 2.23 (1.61–2.90) | 2.13 (1.58–2.63) | 2.13 (1.58–2.63) | 2.37 (1.70–2.80) | 2.76 (2.10–3.31) |
| New-onset pupil dilation and/or anisocoria | 0 | 0 | 0 | 0 | 0 |
| SD overall | SD within | Mean change (95% confidence interval) | pvalue* | ||
| Ventilator FiO2 (%) | 23.72 | 8.59 | − 3.39 (− 7.54 to 0.75) | 0.109 | |
| Peak pressure (mbar) | 3.71 | 1.11 | 0.44 (− 0.63 to 1.51) | 0.420 | |
| MAP (mmHg) | 13.32 | 8.31 | − 1.03 (− 8.31 to 6.25) | 0.781 | |
| Norepinephrine (μg/kg/min) | 0.32 | 0.15 | − 0.23 (− 0.18 to 0.13) | 0.774 | |
| Heart rate (bpm) | 25.84 | 5.68 | − 0.87 (− 5.68 to 3.93) | 0.721 | |
| Pump speed (rpm) | 1305.51 | 159.90 | 0.67 (− 86.46 to 87.80) | 0.988 | |
| Blood flow (l/min) | 0.84 | 0.41 | 0.073 (− 0.15 to 0.29) | 0.512 | |
Data are n [%] or median (25–75% IQR), unless indicated otherwise. For the random-effects general linear regression models, means with standard deviations were calculated. During the observation period, no changes in hemodynamic values, vasopressor dose, respirator, and ECMO settings occurred in temporal relationship to SonoVue administration. Two patients had already dilated pupils at the time of ultrasound study. Both patients died during the 6-h observation period following a decision to withdraw treatment by the treating physician
CPC cerebral performance category, ECMO extracorporeal membrane oxygenation, FiO2 fraction of inspired oxygen, MAP mean arterial pressure, SD standard deviation
*Results from random-effects general linear regression model