End-Tidal Carbon Dioxide Concentration Can Estimate the Appropriate Timing for Weaning Off From Extracorporeal Membrane Oxygenation for Refractory Circulatory Failure
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- Naruke Takashi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Inomata Takayuki
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Imai Hiroshi
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Yanagisawa Tomoyoshi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Maekawa Emi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Mizutani Tomohiro
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Osaka Tsutomu
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Shinagawa Hisahito
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Koitabashi Toshimi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Nishii Mototsugu
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Takeuchi Ichiro
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Takehana Hitoshi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Aoyama Naoyoshi
- Department of Cardio-Angiology, Kitasato University School of Medicine
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- Izumi Tohru
- Department of Cardio-Angiology, Kitasato University School of Medicine
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Although extracorporeal membrane oxygenation (ECMO) is widely used as temporary circulation support, there are no reports of direct parameters indicating cardiac recovery to determine the timing of weaning off.<br>Twenty-five patients supported by ECMO due to hemodynamic deterioration were divided into 2 groups according to their outcome: weaned ECMO (W: n = 18) or not (NW: n = 7). In the W group, we examined the differences in parameters between the 2 time points, ECMO introduction, and the reduction in ECMO flow to 40% of the initial setting known as the conventional recovery point (C-point). Significant differences were observed in systolic pulmonary artery pressure, the cardiac index measured by the thermodilution method, C-reactive protein, lactate, base excess, and the end-tidal CO2 concentration (ETCO2). Next, by closely examining these 6 parameters measured every 12 hours, we found that only ETCO2 had always changed steeply, like a ‘flexion point’ (E-point), in all W cases, but not in NW. The E-point was defined as an initial increase in ETCO2 of ≥ 5 mmHg over the preceding 12 hours with a continued rise over the next 12 hours. E-points appeared as much as 95 ± 60 hours earlier than C-points and also preceded weaning off of ECMO.<br>ETCO2 can be a useful continuous parameter for predicting the adequate timing of weaning off of ECMO for circulatory failure at the bedside.
収録刊行物
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- International Heart Journal
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International Heart Journal 51 (2), 116-120, 2010
一般社団法人 インターナショナル・ハート・ジャーナル刊行会
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詳細情報 詳細情報について
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- CRID
- 1390001205225365888
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- NII論文ID
- 130000250202
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- ISSN
- 13493299
- 13492365
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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