![]() ![]() The mode of ECMO may also alter important clinical factors related to metabolism during critical illness. Previously, it was presumed that ECMO may increase energy expenditure (EE) and protein catabolism, in part due to the associated inflammatory response. Extracorporeal membrane oxygenation can be described as either venoarterial (VA) or venovenous (VV), depending on the site where oxygenated blood is returned. Deoxygenated blood is passed through an external gas exchange system before being returned to the circulation. EE increases during the first week of ICU admission but may be lower than EE in control critically ill patients.Įxtracorporeal membrane oxygenation (ECMO) is a specialised organ support for critically ill patients with severe respiratory and/or cardiac failure. Modified indirect calorimetry is feasible early in admission to ICU but is not possible in all patients receiving VA ECMO, especially later in admission. In patients receiving VA ECMO versus controls, EE was 1577 versus 2092 kcal/d, respectively ( P = 0.056). ![]() The protocol was feasible to complete at T1 (14(67%)) but not at T2 (7(33%)) due to predominantly ECMO decannulation, extubation or death. Twenty-one patients were recruited 16(76%) male, aged 55 years. Measured EE was compared between T1 and T2 and to control patients not receiving VA ECMO. Completion of ≥60% EE measurements was deemed feasible. ![]() Traditional indirect calorimetry via the ventilator was combined with calculations of oxygen consumption and carbon dioxide production derived from pre- and post-ECMO membrane blood gas analyses. EE was measured within 72 h of VA ECMO commencement (timepoint one ) and on approximately day seven of Intensive Care Unit (ICU) admission (timepoint two ). Mechanically ventilated adult patients receiving VA ECMO were included. We aimed to determine the feasibility of using a modified indirect calorimetry protocol in patients receiving VA ECMO, report measured energy expenditure (EE) and compare EE to control critically ill patients. ![]() Traditional indirect calorimetry is unable to capture complete gas exchange in patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO). ![]()
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