초록접수 현황
| 20F-099 | 포스터 발표 |
Measurement of ventriculoarterial coupling as predictor of effective extracorporeal membrane oxygenation support in septic animal model
In-Seok Jeong1, Do-Wan Kim1, Mukhammad Kayumov1, Hwa-Jin Cho2
1.Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
2.Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, Gwangju, Republic of Korea
Purpose : In septic shock that does not respond to conventional treatment, extracorporeal membrane oxygenation (ECMO) has been used as a rescue therapy. However, the precise indicators for predicting successful ECMO treatment in sepsis patients remain uncertain. We intended to find parameters which can indicate a favorable outcome in rat ECMO model with sepsis.
Methods : Twenty Sprague–Dawley rats underwent venoarterial ECMO with jugular vein/femoral artery cannulation for 2 hours. We applied pressure-volume (PV) loop study catheter into left ventricle (LV) and measured hemodynamic parameters, such as ejection fraction (EF), ventriculo-arterial coupling (VAC) and so on. Sepsis was induced by administering 10 mg/kg lipopolysaccharide intraperitoneally 12 hours before the experiment. We classified them into 2 groups based on EF (30%) and VAC (3), and then compared the changes in the PV loop. Sepsis and myocarditis was confirmed with serum endotoxin activity assay and histologic examination in each experiments.
Results : The level of serum endotoxin in pre-ECMO period was 11.9+/-16.8 EU/ml, and histological examination revealed the infiltration of inflammatory cell in myocardium. In better clinical conditions such as higher EF (more than 30%) or the lower VAC (less than 3), the more dominant the right-side shift of PV loop and increase of LV end systolic elastance. This phenomenon was observed more prominent in the case of higher VAC than in the case of lower EF.
Conclusion : Based on the PV loop study, the most positive cardiac performance was confirmed in the case of higher VAC. We suggest that VAC is a promising indicator to predict the effective treatment of ECMO in septic shock.
Methods : Twenty Sprague–Dawley rats underwent venoarterial ECMO with jugular vein/femoral artery cannulation for 2 hours. We applied pressure-volume (PV) loop study catheter into left ventricle (LV) and measured hemodynamic parameters, such as ejection fraction (EF), ventriculo-arterial coupling (VAC) and so on. Sepsis was induced by administering 10 mg/kg lipopolysaccharide intraperitoneally 12 hours before the experiment. We classified them into 2 groups based on EF (30%) and VAC (3), and then compared the changes in the PV loop. Sepsis and myocarditis was confirmed with serum endotoxin activity assay and histologic examination in each experiments.
Results : The level of serum endotoxin in pre-ECMO period was 11.9+/-16.8 EU/ml, and histological examination revealed the infiltration of inflammatory cell in myocardium. In better clinical conditions such as higher EF (more than 30%) or the lower VAC (less than 3), the more dominant the right-side shift of PV loop and increase of LV end systolic elastance. This phenomenon was observed more prominent in the case of higher VAC than in the case of lower EF.
Conclusion : Based on the PV loop study, the most positive cardiac performance was confirmed in the case of higher VAC. We suggest that VAC is a promising indicator to predict the effective treatment of ECMO in septic shock.
책임저자: In-Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
발표자: In-Seok Jeong, E-mail : isjeong1201@gmail.com