Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28645
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dc.contributor.authorStephens, Andrew F-
dc.contributor.authorWickramarachchi, Avishka-
dc.contributor.authorBurrell, Aidan J C-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorRaman, Jaishankar-
dc.contributor.authorGregory, Shaun D-
dc.date2022-02-03-
dc.date.accessioned2022-01-28T05:11:28Z-
dc.date.available2022-01-28T05:11:28Z-
dc.date.issued2022-06-
dc.identifier.citationArtificial organs 2022; 46(6): 1068-1076en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/28645-
dc.description.abstractVenoarterial extracorporeal membrane oxygenation (ECMO) provides mechanical support for critically ill patients with cardiogenic shock. Typically, the size of the arterial return cannula is chosen to maximize flow. However, smaller arterial cannulae may reduce cannula-related complications and be easier to insert. This in vitro study quantified the hemodynamic effect of different arterial return cannula sizes in a simulated acute heart failure patient. Baseline support levels were simulated with a 17 Fr arterial cannula in an ECMO circuit attached to a cardiovascular simulator with targeted partial (2.0 L/min ECMO flow, 60-65 mmHg mean aortic pressure - MAP) and targeted full ECMO support (3.5 L/min ECMO flow and 70-75 mmHg MAP). Return cannula size was varied (13-21 Fr), and hemodynamics were recorded while keeping ECMO pump speed constant and adjusting pump speed to restore desired support levels. Minimal differences in hemodynamics were found between cannula sizes in partial support mode. A maximum pump speed change of +600 rpm was required to reach the support target and arterial cannula inlet pressure varied from 79 (21 Fr) to 224 mmHg (13 Fr). The 15 Fr arterial cannula could provide the target full ECMO support at the targeted hemodynamics; however, the 13 Fr cannula could not due to the high resistance associated with the small diameter. A 15 Fr arterial return cannula provided targeted partial and full ECMO support to a simulated acute heart failure patient. Balancing reduced cannula size and ECMO support level may improve patient outcomes by reducing cannula-related adverse events.en
dc.language.isoeng
dc.subjectArterial Cannulaen
dc.subjectBleedingen
dc.subjectECMOen
dc.subjectECPRen
dc.subjectIschemiaen
dc.subjectOut of Hospital Cannulationen
dc.subjectReturn Cannulaen
dc.subjectVascular Injuryen
dc.titleThe Hemodynamics of Small Arterial Return Cannulae for Venoarterial Extracorporeal Membrane Oxygenation.en
dc.typeJournal Articleen
dc.identifier.journaltitleArtificial organsen
dc.identifier.affiliationIntensive Care..en
dc.identifier.affiliationCardio-respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia..en
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia..en
dc.identifier.affiliationDepartment of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia..en
dc.identifier.affiliationDepartment of Critical Care, The University of Melbourne, Melbourne, Australia..en
dc.identifier.affiliationIntensive Care Unit, Alfred Hospital, Melbourne, Australia..en
dc.identifier.affiliationCardiothoracic Surgery, University of Melbourne, Melbourne, Australia..en
dc.identifier.affiliationDepartment of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia..en
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/35049072/en
dc.identifier.doi10.1111/aor.14179en
dc.type.contentTexten
dc.identifier.orcid0000-0002-2271-750Xen
dc.identifier.orcid0000-0003-2623-7009en
dc.identifier.orcid0000-0001-8430-9678en
dc.identifier.orcid0000-0002-5448-1917en
dc.identifier.orcid0000-0002-1650-8939en
dc.identifier.pubmedid35049072
local.name.researcherBellomo, Rinaldo
item.grantfulltextnone-
item.openairetypeJournal Article-
item.languageiso639-1en-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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