Hemodynamic adaptation of heart failure to percutaneous venoarterial extracorporeal circulatory supports

Title:

Hemodynamic adaptation of heart failure to percutaneous venoarterial extracorporeal circulatory supports

Creator:

Hála, Pavel and Kittnar, Otomar

Identifier:

https://cdk.lib.cas.cz/client/handle/uuid:408ff9f9-01cd-4566-9a27-5fecdca55df0
uuid:408ff9f9-01cd-4566-9a27-5fecdca55df0
issn:0862-8408
doi:10.33549/physiolres.934332

Subject:

extrakorporální membránová oxygenace, srdeční selhání, hemodynamika, extracorporeal membrane oxygenation, heart failure, hemodynamics, ventricular overload, perfusion, 14, and 612

Type:

model:article and TEXT

Format:

počítač and online zdroj

Description:

Extracorporeal life support (ECLS) is a treatment modality that provides prolonged blood circulation, gas exchange and can partially support or fully substitute functions of heart and lungs in patients with severe but potentially reversible cardiopulmonary failure refractory to conventional therapy. Due to high-volume bypass, the extracorporeal flow is interacting with native cardiac output. The pathophysiology of circulation and ECLS support reveals significant effects on arterial pressure waveforms, cardiac hemodynamics, and myocardial perfusion. Moreover, it is still subject of research, whether increasing stroke work caused by the extracorporeal flow is accompanied by adequate myocardial oxygen supply. The left ventricular (LV) pressure-volume mechanics are reflecting perfusion and loading conditions and these changes are dependent on the degree of the extracorporeal blood flow. By increasing the afterload, artificial circulation puts higher demands on heart work with increasing myocardial oxygen consumption. Further, this can lead to LV distention, pulmonary edema, and progression of heart failure. Multiple methods of LV decompression (atrial septostomy, active venting, intra-aortic balloon pump, pulsatility of flow) have been suggested to relieve LV overload but the main risk factors still remain unclear. In this context, it has been recommended to keep the rate of circulatory support as low as possible. Also, utilization of detailed hemodynamic monitoring has been suggested in order to avoid possible harm from excessive extracorporeal flow., Pavel Hála, Otomar Kittnar., and Obsahuje bibliografii

Language:

English

Rights:

http://creativecommons.org/publicdomain/mark/1.0/
policy:public

Coverage:

739-757

Source:

Physiological research | 2020 Volume:69 | Number:5

Harvested from:

CDK

Metadata only:

false