The physiology of extracorporeal membrane oxygenation: The Fick principle
Hoong Sern Lim
Abstract
Extracorporeal membrane oxygenation (ECMO) can be delivered in veno-arterial (VA) and veno-venous (VV) configurations based on the cannulation strategy. VA and VV ECMO are delivered primarily for haemodynamic and respiratory support in patients with severe heart and lung failure, respectively. The Fick principle describes the relationship between blood flow and oxygen consumption - key parameters in the physiological management of extracorporeal support. This review will discuss the application of the Fick principle in: (i) recirculation in VV ECMO; (ii) the quantification of oxygen delivery (DO2) in VV ECMO and (iii) the quantification of transpulmonary blood flow and systemic arterial oxygen saturation in VA ECMO.
Topics & Concepts
MedicineExtracorporeal membrane oxygenationExtracorporealHemodynamicsFick principleOxygenationExtracorporeal circulationOxygen deliveryBlood oxygenationAnesthesiaArtificial lungBlood flowOxygen saturationCardiac outputCardiologyOxygenIntensive care medicineInternal medicineOrganic chemistryChemistryFunctional magnetic resonance imagingRadiologyMechanical Circulatory Support DevicesCardiac Arrest and ResuscitationHeart Failure Treatment and Management