Abstract
Aim: To compare recirculation fraction (Rf) between femoro-jugular (fem-jug) and jugulo-femoral (jug-fem) venovenous extracorporeal membrane oxygenation (VV ECMO) and to identify risk factors for recirculation.
Method: Patients receiving VV ECMO with fem-jug, and jug-fem configuration were included in this prospective study. Total ECMO flow (QEC), recirculated flow (QREC), and Rf (=QREC/QEC) were analyzed using ultrasound dilution technology. Effective ECMO flow (QEFF) was defined as QEFF=QEC*(1–Rf). Survival was assessed at discharge from ICU.
Result: 37 patients with fem-jug and 18 patients with jug-fem configuration underwent 595 and 231 measurements, respectively. Rf was lower with fem-jug (5 [0; 11] vs 19 [13; 28] %, p<0.001), resulting in similar QEFF (2.8 [2.2; 3.4] vs 2.8 [2.4; 3.1] L/min, p=0.225) despite lower QEC with fem-jug configuration compared to jug-fem (3.0 [2.4; 3.7] vs 3.6 [3.1; 4.1] L/min, p<0.001, Figure 1).
In multivariate regression analysis, the type of configuration, distance between the two cannula tips, ECMO flow, and heart rate were significantly associated with Rf (B [95%-CI]: 25.8 [17.6; 33.8], p<0.001; –0.4 (–0.7; –0.1), p=0.009; 4.2 (2.5; 5.9), p<0.001; –0.1 [–0.2; 0.0], p=0.027). Survival was comparable (femoro-jugular 81% vs jugulo-femoral group vs. 72%, p=0.455).
Conclusion: VV ECMO with fem-jug configuration caused less recirculation. Further risk factors were distance between the cannulae, QEC, and heart rate.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 96.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022
