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Vol.58 (2012) >

Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/318

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Title: The endocrinological responses of veno-venous extracorporeal membrane oxygenation on hypoxic fetal lambs
Other Titles: The endocrinological responses of V-V ECMO on hypoxic fetal lambs
Authors: Nomura, Yasuhisa
Kato, Katsuhiko
Fujimori, Keiya
Shiroto, Tomohiro
Ishida, Tomohiko
Sato, Akira
Affiliation: 産科婦人科学講座
Source title: Fukushima Journal of Medical Science
Volume: 58
Issue: 1
Start page: 9
End page: 16
Issue Date: 2012
Abstract: Objective: The purpose of this study was to observe endocrinological responses of veno-arterial and veno-venous extracorporeal membrane oxygenation (V-A and V-V ECMO) to support fetal oxygenation in utero. Methods: An ECMO system with a centrifugal pump was applied to six chronically instrumented fetal lambs, at 126-134 days of gestation. Blood was obtained through a double-lumen catheter inserted into the right atrium. After oxygenation, the blood was returned through a single-lumen catheter into either the carotid artery (veno-arterial; V-A ECMO) or the right atrium (V-V ECMO). After fetal hypoxia had been experimentally produced, V-A ECMO or V-V ECMO was instituted to maintain fetal oxygenation. We compared fetal blood gases and concentrations of atrial natriuretic peptide (ANP), epinephrine and norepinephrine with both routes of ECMO. Results: Fetal carotid artery pH did not change during hypoxemia, but decreased after instituting V-A ECMO and V-V ECMO. After instituting V-A ECMO or V-V ECMO for 30 min, oxygen partial pressure (pO2) in the fetal cranial carotid artery recovered from the hypoxic level. The ANP concentration in V-V ECMO was significantly lower than that in V-A ECMO. Fetal serum epinephrine and norepinephrine concentrations significantly increased in association with hypoxic stimulation. There was a further increase in fetal serum epinephrine concentration after instituting V-A ECMO. No significant difference in concentration was found after instituting V-V ECMO from that of after the institution of V-A ECMO. Conclusions: This study suggested that V-V ECMO may possibly be less invasive than V-A ECMO for fetal heart, because ANP, a cardiac distress index, was lower in V-V ECMO than in V-A ECMO.
Publisher: The Fukushima Society of Medical Science
Publisher (Alternative foam): 福島医学会
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/318
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/318/1/FksmJMedSci_58_p9.pdf
ISSN: 0016-2590
DOI: 10.5387/fms.58.9
PubMed ID: 22790887
Other version: http://dx.doi.org/10.5387/fms.58.9
Rights: © 2012 The Fukushima Society of Medical Science
Appears in Collections:Vol.58 (2012)

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