Rat model of veno-arterial extracorporeal membrane oxygenation

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Abstract

Background

We aim to develop a rat model of veno-arterial extracorporeal membrane oxygenation (VA-ECMO).

Methods

VA-ECMO was established in twelve Male Sprague-Dawley rats (250-350 g) through cannulation of the right jugular vein for venous drainage and the right femoral artery for arterial reinfusion. Arterial blood pressure was measured using a conductance catheter through cannulation of the left carotid artery. Heart rate was monitored by electrocardiography and arterial blood gas parameters with a blood gas analyzer. The VA-ECMO circuit was tested by subjecting the rats to hypoxic cardiac arrest with resuscitation using VA-ECMO. Both load-dependent and load-independent measures of myocardial contractility were measured using pressure-volume loop analysis to confirm restoration of myocardial function post-resuscitation.

Results

Following hypoxic cardiac arrest VA-ECMO provided sufficient oxygenation to support the circulation. The haemodynamic and blood gas parameters were maintained at transition and during ECMO. All animals were resuscitated, regained cardiac function and were able to be weaned off ECMO post-resuscitation.

Conclusion

We have established a safe, high-throughput, economical, functioning rat model of VA-ECMO.

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Most cited references 5

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A 5-year experience with cardiopulmonary resuscitation using extracorporeal life support in non-postcardiotomy patients with cardiac arrest.

Assad Haneya, Alois Philipp, Claudius Diez … (2012)

Cardiopulmonary resuscitation (CPR) using extracorporeal life support (ECLS) system has been successfully used to support patients with in- and out-of-hospital cardiac arrest (IHCA, OHCA) when conventional measures have failed. The purpose of the current study is to report on our experience with extracorporeal CPR in non-postcardiotomy patients. We retrospectively analysed a total of 85 consecutive adult patients, who have been treated with ECLS between January 2007 and January 2012. The mean CPR duration was 40 min (20-70 min). The mean ECLS support duration was 49 h (12-92 h). Twenty-eight patients (33%) had ECLS related complications. Forty patients (47%) were successfully weaned and 29 patients (34%) survived to hospital discharge. Among survivors, 93% were without severe neurologic deficit. Duration of CPR was shorter for survivors than for non-survivors [(25: 20-50 min) vs. (50: 25-86 min); p=0.003]. Immediately after ECLS start, the mean blood lactate level was lower (p=0.003), and the mean pH value was higher in the survivors' group (p<0.0001) compared to the non-survivors' group. The CPR duration for the IHCA group (25: 20-50 min) was shorter compared to the OHCA group (70: 55-110min; p<0.0001). The survival rate in this group was higher compared to the OHCA group (42% vs. 15%; p<0.02). CPR using modern miniaturized ECLS systems should be established in the treatment of prolonged cardiac arrest and unsuccessful conventional CPR in selected patients. CPR with ECLS for OHCA has worse outcomes compared to IHCA. Duration of CPR was independent risk factor for mortality after extracorporeal CPR. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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Percutaneous venoarterial extracorporeal membrane oxygenation for emergency mechanical circulatory support.

P Mair, C Hoermann, M Moertl … (1996)

In this retrospective study we report our initial experience with percutaneous venoarterial extracorporeal membrane oxygenation in the emergency treatment of intractable cardiogenic shock or pulseless electrical activity. Between January 1994 and July 1995, percutaneous venoarterial extracorporeal membrane oxygenation was attempted in seven patients (pulseless electrical activity, five patients; cardiogenic shock, two patients). In two of the seven patients, efforts at arterial cannulation resulted in cannula perforation at the level of the iliac artery. In the remaining five patients, percutaneous venoarterial extracorporeal membrane oxygenation could be established and was maintained for 3-84 h. Major bleeding remained a common complication during extracorporeal membrane oxygenation despite the use of heparin-coated bypass circuits and was responsible for death during extracorporeal membrane oxygenation in one patient. The remaining four patients could be weaned from mechanical circulatory support within 24 h, two after surgical interventions (resection of right atrial tumor, heart transplantation), one after thrombolytic therapy. In one patient, cardiac function recovered spontaneously after 6 h on venoarterial extracorporeal membrane oxygenation. Three patients were discharged from hospital, two of them made a full recovery, one sustained severe hypoxic brain injury. A few patients with intractable cardiogenic shock or pulseless electrical activity can be resuscitated with the help of emergency percutaneous venoarterial extracorporeal membrane oxygenation. Emergency venoarterial extracorporeal membrane oxygenation is associated with a high rate of complications and its use should therefore be limited to selected patients with a rapidly correctable underlying cardiopulmonary pathology (anatomic, metabolic or hypothermic) who do not respond to conventional advanced cardiac life support.

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Extracorporeal membrane oxygenation in the acute treatment of cardiovascular collapse immediately post-partum.

W Robert Leeper, Matthew Valdis, Shu-Xia Guo … (2013)

We describe the use of extracorporeal membrane oxygenation (ECMO) in a 30-year old woman at 37 weeks' gestation, following cardiac arrest from pulmonary embolism immediately post-partum from an emergent Caesarean section. In this case, ECMO was initiated though modified techniques with only the equipment available in a delivery room as a last resort to save a new mother after a significant downtime of 83 min. The patient received tissue plasminogen activator during the resuscitation resulting in significant blood loss. However, the patient was stabilized on ECMO and after 5 weeks in the intensive care unit achieved complete physical and neurologic recovery. To our knowledge, this is the first reported case where ECMO has been used in a resuscitation from massive pulmonary embolism immediately post-partum, after thombolytics were administered. Here, we discuss our strategies for emergent cannulation in a suboptimal environment, management of profound bleeding and oxygenation strategies in this hostile setting. Given the potential for success and the significant life-years gained, aggressive measures, such as ECMO, should be considered in such extreme life-threatening cases.

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Author and article information

Journal

Journal ID (nlm-ta): J Transl Med

Journal ID (iso-abbrev): J Transl Med

Title: Journal of Translational Medicine

Publisher: BioMed Central

ISSN (Electronic): 1479-5876

Publication date Collection: 2014

Publication date (Electronic): 7 February 2014

Volume: 12

Page: 37

Affiliations

[1 ]Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, 161 Fort Washington Avenue, Herbert Irving Pavilion, 6th Floor, New York, NY 10032, USA

[2 ]Cardiovascular Research Foundation, New York, NY, USA

[3 ]Zena and Michael A. Weiner Cardiovascular Institute, Mount Sinai School of Medicine, One Gustav Levy Place, New York, NY 10029, USA

[4 ]Division of Cardiovascular Medicine, Stanford University, 870 Quarry Road, Stanford, CA 94305, USA

[5 ]Department of Cardiothoracic Surgery, Papworth Hospital and University of Cambridge, Cambridge, CB23 3RE, United Kingdom

[6 ]University of Alberta and Mazankowski Alberta Heart Institute, 8440 112 St NW, Edmonton, AB T6G 2P4, Canada

Article

Publisher ID: 1479-5876-12-37

DOI: 10.1186/1479-5876-12-37

PMC ID: 3925959

PubMed ID: 24507588

SO-VID: 0ec10e6c-f5ed-46e3-bc5f-da3c3a7ba1b7

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Rat model of veno-arterial extracorporeal membrane oxygenation

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Abstract

Background

Methods

Results

Conclusion

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Animal models of intrauterine growth restriction (IUGR)

Most cited references 5

A 5-year experience with cardiopulmonary resuscitation using extracorporeal life support in non-postcardiotomy patients with cardiac arrest.

Percutaneous venoarterial extracorporeal membrane oxygenation for emergency mechanical circulatory support.

Extracorporeal membrane oxygenation in the acute treatment of cardiovascular collapse immediately post-partum.

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