Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in treatment of decompensated heart failure. Our aim was to investigate its effects on regional perfusion and tissue oxygenation with respect to extracorporeal blood flow (EBF). In five swine, decompensated low-output chronic heart failure was induced by long-term rapid ventricular pacing. Subsequently, VA ECMO was introduced and left ventricular (LV) volume, aortic blood pressure, regional arterial flow and tissue oxygenation were continuously recorded at different levels of EBF. With increasing EBF from minimal to 5 l/min, mean arterial pressure increased from 47+/-22 to 84+/-12 mm Hg (P<0.001) and arterial blood flow increased in carotid artery from 211+/-72 to 479+/-58 ml/min (P<0.01) and in subclavian artery from 103+/-49 to 296+/-54 ml/min (P<0.001). Corresponding brain and brachial tissue oxygenation increased promptly from 57+/-6 to 74+/-3 % and from 37+/-6 to 77+/-6 %, respectively (both P<0.01). Presented results confirm that VA ECMO is a capable form of heart support. Regional arterial flow and tissue oxygenation suggest that partial circulatory support may be sufficient to supply brain and peripheral tissue by oxygen.

• MeSH
• arteria femoralis metabolismus   MeSH
• arteria subclavia metabolismus   MeSH
• arteriae carotides metabolismus   MeSH
• chronická nemoc MeSH
• koronární cévy metabolismus   MeSH
• mimotělní membránová oxygenace metody   MeSH
• oxymetrie metody   MeSH
• prasata MeSH
• rychlost toku krve fyziologie   MeSH
• srdeční selhání metabolismus   terapie   MeSH
• vena femoralis metabolismus   MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The aims were to explore the effect of head-up tilt (HUT) to 30 and 60 degrees on hemodynamics and tissue oxygenation in anesthetized healthy swine. The data serve as a reference for a study of resuscitation efficacy at HUT such as during transport. Nine healthy swine (49+/-4 kg) were anesthetized and multiple sensors including myocardial pressure-volume loops catheter, carotid flow probe, blood pressure catheters, near infrared spectroscopy (NIRS) tissue oximetry and mixed venous oximetry (SVO2) catheter were introduced and parameters continuously recorded. Experimental protocol consisted of baseline in supine position (15 min), 30 degrees HUT (15 min), recovery at supine position (15 min) and 60 degrees HUT (5 min). Vacuum mattress was used for body fixation during tilts. We found that 30 and 60 degrees inclination led to significant immediate reduction in hemodynamic and oximetry parameters. Mean arterial pressure (mm Hg) decreased from 98 at baseline to 53 and 39, respectively. Carotid blood flow dropped to 47 % and 22 % of baseline values, end diastolic volume to 49 % and 53 % and stroke volume to 47 % and 45 % of baseline. SVO2 and tissue oximetry decreased by 17 and 21 percentage points. The values are means. In conclusions, within minutes, both 30 and 60 degrees head-up tilting is poorly tolerated in anesthetized swine. Significant differences among individual animals exist.

• MeSH
• arteriae carotides patofyziologie   MeSH
• arteriální tlak MeSH
• blízká infračervená spektroskopie MeSH
• časové faktory MeSH
• celková anestezie * MeSH
• hemodynamika * MeSH
• kyslík krev   MeSH
• modely u zvířat MeSH
• ortostatická intolerance krev   patofyziologie   MeSH
• oxymetrie metody   MeSH
• postura těla * MeSH
• prasata MeSH
• regionální krevní průtok MeSH
• spotřeba kyslíku MeSH
• supinační poloha MeSH
• test na nakloněné rovině MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• kyslík MeSH

The adequacy of cerebral blood flow and the level of regional oxygen saturation during CPR and early post-resuscitation phases assuring favorable neurological outcome are not known. We demonstrate the feasibility of cerebral blood flow and oxygenation monitoring by a continuous transcranial Doppler combined with cerebral oximetry in a patient with refractory cardiac arrest treated by extracorporeal life support.

• Klíčová slova
• cardiac arrest, cerebral blood flow, cerebral oxygenation, cerebral oxymetry, extracorporeal life support, transcranial Doppler,
• MeSH
• dospělí MeSH
• lidé MeSH
• mimotělní oběh metody   MeSH
• mozkový krevní oběh * MeSH
• oxymetrie metody   MeSH
• rychlost toku krve MeSH
• ultrasonografie dopplerovská transkraniální metody   MeSH
• vyvolaná zástava srdce metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH