The Lancet Technology: February, 2012

摘要

Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with cardiorespiratory failure which exposes the patient to the risk for intracranial injury. We used a 12-channel optical topography system to monitor cerebral oxygenation in a venoarterial (VA) ECMO patient during alterations in the ECMO flows. Changes in oxy-(HbO 2), deoxy-(HHb) and total-(HbT) haemoglobin concentrations were measured simultaneously with systemic and ECMO circuit parameters. Decreasing the flows resulted in a decrease in venous (SvO 2) and arterial (SpO 2) saturations. These were reflected in the haemoglobin data by a significant increase in HHb of varying magnitude across the 12 channels and moderate changes in HbO 2 suggestive of cerebral arterial dilation to compensate for the lack of oxygen delivery. In the patient studied here, ECMO flows appear to present a significant haemodynamic challenge to cerebral circulation.