• Gottfried J Locker, Heidrun Losert, Peter Schellongowski, Florian Thalhammer, Sylvia Knapp, Klaus F Laczika, Heinz Burgmann, Thomas Staudinger, Michael Frass, and Manfred Muhm.
• Department of Internal Medicine I, Intensive Care Unit, University Hospital of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. gottfried.locker@akh-wien.ac.at
• J Clin Anesth. 2003 Sep 1; 15 (6): 441-5.

Study ObjectiveTo investigate prospectively whether blood gas samples drawn from extracorporeal membrane oxygenation (ECMO) cannulae help to exclude at least clinically significant recirculation volumes in patients with acute respiratory failure.DesignFeasibility study.SettingIntensive care unit at a university-affiliated hospital.PatientsTen consecutive adult patients suffering from severe respiratory failure and undergoing ECMO.InterventionsThe drawing (venous) ECMO cannula was placed into the inferior vena cava via a femoral vein, and the oxygenated blood was returned via the right subclavian vein by supraclavicular access directly into the right atrium. Blood gas samples were obtained from both cannulae.Measurements And Main ResultsThe median arterial oxygen tension (PaO(2)) obtained from the arterial cannula was 537 mmHg (range, 366 to 625 mmHg), the median mixed venous oxygen tension (PvO(2)) drawn from the venous cannula was 42 mmHg (range, 25 to 54 mmHg), which was less than 10% of that observed in the arterial cannula, and also within the physiologic range of PvO(2). The ECMO flow necessary to maintain patients' oxygen saturation above 90% (4.1 L/min; range, 1.95 to 5.8 L/min) was significantly lower than the patients' cardiac output (CO; 6.2 L/min; range, 4.1 to 7.9 L/min; p < 0.001). CONSLUSIONS; We recommend obtaining blood gas samples-immediately after initiation of ECMO-from both cannulae. A PvO(2) within physiologic range and below 10% of PaO(2) rules out any clinically relevant recirculation volume.

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