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03 March 2016 : Laboratory Research  

Hemodynamic Differences Between Central ECMO and Peripheral ECMO: A Primary CFD Study

Kaiyun GuADE, Ya ZhangBC, Bin GaoFG, Yu ChangAG, Yi ZengA

DOI: 10.12659/MSM.895831

Med Sci Monit 2016; 22:717-726


BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VAECMO), including central ECMO (cECMO) and peripheral ECMO (pECMO), is widely used in cardiopulmonary surgery. The outcomes and complications of both types of ECMO are quite different from each other. The hemodynamic differences among them are hypothesized as a key factor. Hence, a numerical study was conducted to test this hypothesis.

MATERIAL AND METHODS: Ideal cardiovascular models with pECMO and cECMO were established. The aortic pressure and flow rate were chosen as boundary conditions. The flow pattern, blood flow distributions, flow junction, harmonic index (HI) of blood flow, wall shear stress (WSS), and the oscillatory shear index (OSI) were calculated to evaluate the hemodynamic states.

RESULTS: pECMO could achieve better upper limb and brain perfusion (0.05458 vs. 0.05062 kg/s), and worse lower limb perfusion (0.03067 vs. 0.03401 kg/s). There exist low WSS (<0.4 pa) regions at the inner and posterior wall of the aorta, and high WSS (>2 pa) region at the access of the femoral artery. These regions also have relatively high OSI value (reaching 0.45). In contrast, for cECMO, there exist high WSS at the posterior wall of the aortic arch.

CONCLUSIONS: The hemodynamic performances of various types of ECMO are different from each other, which maybe the key reasons for the differences in the outcomes and complications. Therefore, for pEMCO, the lower-extremity ischemia is a complication that must be considered. The type, support level, and duration of ECMO should also be carefully regulated according to the patients’ condition, as they are the important factors related to vascular complications.

Keywords: Extracorporeal Membrane Oxygenation, Aorta - physiology, Hemodynamics - physiology, hydrodynamics, Stress, Mechanical



01 December 2022 : Editorial  

Editorial: The World Health Organization (WHO) Fungal Priority Pathogens List in Response to Emerging Fungal Pathogens During the COVID-19 Pandemic

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.939088

Med Sci Monit 2022; 28:e939088


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In Press

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Med Sci Monit In Press; DOI: 10.12659/MSM.937737  

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Med Sci Monit In Press; DOI: 10.12659/MSM.938389  

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Med Sci Monit In Press; DOI: 10.12659/MSM.938674  

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750