{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T15:43:52Z","timestamp":1763480632146,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pulsatile\u2010flow veno\u2010arterial extracorporeal membrane oxygenation (V\u2010A ECMO) has shown encouraging results for microcirculation resuscitation and left ventricle unloading in patients with refractory cardiogenic shock. We aimed to comprehensively assess different V\u2010A ECMO parameters and their contribution to hemodynamic energy production and transfer through the device circuit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used the i\u2010cor\u00ae ECMO circuit, which composed of Deltastream DP3 diagonal pump and i\u2010cor\u00ae console (Xenios AG), the Hilite 7000 membrane oxygenator (Xenios AG), venous and arterial tubing and a 1\u2009L soft venous pseudo\u2010patient reservoir. Four different arterial cannulae (Biomedicus 15 and 17 Fr, Maquet 15 and 17 Fr) were used. For each cannula, 192 different pulsatile modes were investigated by adjusting flow rate, systole\/diastole ratio, pulsatile amplitudes and frequency, yielding 784 unique conditions. A dSpace data acquisition system was used to collect flow and pressure data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Increasing flow rates and pulsatile amplitudes were associated with significantly higher hemodynamic energy production (both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), while no significant associations were seen while adjusting systole\u2010to\u2010diastole ratio (<jats:italic>p<\/jats:italic>\u2009=\u20090.73) or pulsing frequency (<jats:italic>p<\/jats:italic>\u2009=\u20090.99). Arterial cannula represents the highest resistance to hemodynamic energy transfer with 32%\u201359% of total hemodynamic energy generated being lost within, depending on pulsatile flow settings used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Herein, we presented the first study to compare hemodynamic energy production with all pulsatile ECLS pump settings and their combinations and widely used yet previously unexamined four different arterial ECMO cannula. Only increased flow rate and amplitude increase hemodynamic energy production as single factors, whilst other factors are relevant when combined.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14523","type":"journal-article","created":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T13:03:07Z","timestamp":1679144587000},"page":"1122-1132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A comprehensive evaluation of hemodynamic energy production and circuit loss using four different <scp>ECMO<\/scp> arterial cannulae"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-4816","authenticated-orcid":false,"given":"Silver","family":"Heinsar","sequence":"first","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"Critical Care Research Group St Andrews War Memorial Hospital  Brisbane Queensland Australia"},{"name":"Department of Intensive Care North Estonia Medical Centre  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Bartnikowski","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunter","family":"Hartel","sequence":"additional","affiliation":[{"name":"Statistics Unit QIMR Berghofer Medical Research Institute  Herston Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samia M.","family":"Farah","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland 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Maria","family":"Colombo","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Department of Anaesthesia and Intensive Care Medicine Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Lombardia Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Lombardia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clayton","family":"Semenzin","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Lombardia Italy"},{"name":"School of Engineering and Built Environment Griffith University  Southport Queensland 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Queensland Australia"},{"name":"School of Engineering and Built Environment Griffith University  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"Critical Care Research Group St Andrews War Memorial Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacky Y.","family":"Suen","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland 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