Extracorporeal Membrane Oxygenation Cannulation Site Affects Coronary and Cerebral Perfusion When Combined With Intra-Aortic Balloon Pump

Article Article scientifique Article Extracorporeal Membrane Oxygenation Cannulation Site Affects Coronary and Cerebral Perfusion When Combined With Intra-Aortic Balloon Pump eng 2025-05-13 author Sibut-Pinote Vincent 0009-0009-5343-1422 From the Charles Hahn Hemodynamic Propulsion Laboratory, Medical Faculty, University of Geneva, Geneva, Switzerland. 905362 author Reymond Philippe 0000-0002-0772-6862 From the Charles Hahn Hemodynamic Propulsion Laboratory, Medical Faculty, University of Geneva, Geneva, Switzerland.,Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland. 729770 Département de radiologie et informatique médicale (RADIO) author Cikirikcioglu Mustafa From the Charles Hahn Hemodynamic Propulsion Laboratory, Medical Faculty, University of Geneva, Geneva, Switzerland.,Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland. 135609 Département de chirurgie (CHIRU) author Bendjelid Karim 0000-0002-7921-7207 Department of Anesthesiology, Pharmacology and Intensive Care, Geneva Hemodynamic Research Group, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland. 527948 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Huber Christoph 0000-0001-9048-849X From the Charles Hahn Hemodynamic Propulsion Laboratory, Medical Faculty, University of Geneva, Geneva, Switzerland.,Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland. 853395 Département de chirurgie (CHIRU) 10.1097/mat.0000000000002454 40377242 1058-2916 https://journals.lww.com/10.1097/MAT.0000000000002454 The use of intra-aortic balloon pump (IABP) alongside venoarterial extracorporeal membrane oxygenation (VA-ECMO) in critically ill patients presenting refractory cardiogenic shock raises questions regarding its impact on organs perfusion. This in vitro study aimed to examine the combined effects of IABP and VA-ECMO on coronary, cerebral, and renal perfusion, particularly considering the choice of arterial cannulation site. A mock circuit with a pulsatile pump was used to simulate different scenarios with increasing severities of low cardiac output syndromes treated by concomitant IABP and VA-ECMO support. Flow rates were measured using ultrasonic flowmeters. Each scenario was tested with two different VA-ECMO outflow access sites: femoral and axillary arteries, at heart rates of 60 and 100 bpm. Results showed that concomitant use of IABP with VA-ECMO in the axillary artery increases more significantly cerebral and coronary flow rates compared to femoral access in intermediate and severe shock. Nevertheless, renal perfusion appeared to be more negatively affected in this configuration. In summary, employing IABP alongside axillary VA-ECMO enhances cerebral and coronary flow but may compromise renal perfusion. Shock severity, heart rate, and cannulation site should be considered for a tailored approach. Future investigations using sophisticated autoregulated systems are needed to confirm these observations. ECMO IABP Cerebral blood flow Coronary blood flow Low cardiac output syndrome Renal blood flow Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 57 Département de chirurgie 222 false 570 Groupe de recherche en hémodynamique 913 1290 Recherche cardiovasculaire et de propulsion hémodynamique 1009 ASAIO journal d1c70970-8ae1-4a11-bff2-90ab760a6358 Article (Published version) Public Reymond-extracorporeal_membrane_oxy.pdf 867984 application/pdf CC BY-4.0 531f93bfbe19e16723e823b2ced9c663954af395d1c6d116b725d97f5854fe99 openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Extracorporeal Membrane Oxygenation Cannulation Site Affects Coronary and Cerebral Perfusion When Combined With Intra-Aortic Balloon Pump	ASAIO journal			2025	86	245

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Sibut-Pinote, Vincent