Descripción de parámetros de perfusión de pacientes con terapia de oxigenación por membrana extracorpórea en La Cardio

Abstract

Introduction: Patients undergoing VA-ECMO, are those that due to their critical status require a partial or total mechanical cardiovascular support; guaranteeing optimal tissue perfusion is paramount in these type of patients It’s of utmost importance to describe the behavior of perfusion parameters (NIRS, arterial lactate, Venous Saturation and CO2) while on therapy in order to assess adequate application Methods: A retrospective descriptive observational study was performed analyzing 722 moments of paired monitoring parameters and blood gases from 28 VA-ECMO from december 2018 to november 2019. We performed descriptive statistics, and a bivariate analysis from premembrane and venous blood gases. Results: Eleven patients died, nine died while in therapy and two died after weaning and decannulation. One patient died early without blood gases. The iDO2/iVO2 ratio was in average 4,2:1 ( SD 1,91) while on therapy. All perfusion parameters evaluated where within normal range according to reference literature Among survivors and non-survivor groups lower cerebral NIRS (p=0,003) and higher lactate (p=0,001) at baseline in the latter group, No difference between CO2 (p=0,27) or SvO2 (p=0,25) at baseline . Differences were observed between venous and premembrane saturations close to 4% (p=0,06) when evaluated from paired samples. Conclusions: Perfusion parameters were maintained within optimal parameters maintaining adequate oxygen delivery and consumption ratios. Non-Survivors had lower cerebral NIRS and higher lactate at baseline