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Optimization of extracorporeal membrane oxygenation therapy using near‐infrared spectroscopy to assess changes in peripheral circulation: A pilot study
Author(s) -
Chang HsiaoHuang,
Chen YiChih,
Huang ChunJung,
Kuo ChiaCheng,
Wang YiMin,
Sun ChiaWei
Publication year - 2020
Publication title -
journal of biophotonics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.877
H-Index - 66
eISSN - 1864-0648
pISSN - 1864-063X
DOI - 10.1002/jbio.202000116
Subject(s) - extracorporeal membrane oxygenation , medicine , peripheral , circulatory system , perfusion , oxygenation , extracorporeal circulation , blood flow , anesthesia , cardiology , catheter , surgery
Near‐infrared spectroscopy (NIRS) has been proposed as a noninvasive modality for detecting complications in patients undergoing extracorporeal membrane oxygenation (ECMO), and it can simultaneously reveal the global circulatory status of these patients. We optimized ECMO therapy on the basis of real‐time peripheral NIRS probing. Three patients underwent venoarterial (VA) ECMO and one patient underwent venovenous (VV) ECMO. All patients received peripheral ECMO cannulation with routine distal perfusion catheter placement. We designed an experimental protocol to adjust ECMO blood flow over 1 hour. Hemodynamic responses were measured using NIRS devices attached to the calf at approximately 60% of the distance from the ankle to the knee. HbO 2 levels change substantially with adjustments in ECMO flow, and they are more sensitive than HHb levels and the tissue saturation index (TSI) are. NIRS for optimizing ECMO therapy may be reliable for monitoring global circulatory status.