{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:17:34Z","timestamp":1777544254036,"version":"3.51.4"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,3,24]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Extracorporeal membrane oxygenation (\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              ) provides a bridge to recovery after myocardial injury in infants and children, yet morbidity and mortality remain high. Weaning from the circuit requires adequate cardiac contractile function, which can be impaired by metabolic disturbances induced either by ischemia\u2010reperfusion and\/or by\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              . We tested the hypothesis that although\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              partially ameliorates metabolic abnormalities induced by\n              <jats:styled-content style=\"fixed-case\">ischemia\u2010reperfusion<\/jats:styled-content>\n              , these abnormalities persist or recur with weaning. We also determined if thyroid hormone supplementation (triiodothyronine) during\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              improves oxidative metabolism and cardiac function.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Neonatal piglets underwent transient coronary ischemia to induce cardiac injury then were separated into 4 groups based on loading status. Piglets without coronary ischemia served as controls. We infused into the left coronary artery [2\u2010\n              <jats:sup>13<\/jats:sup>\n              C]pyruvate and [\n              <jats:sup>13<\/jats:sup>\n              C\n              <jats:sub>6<\/jats:sub>\n              ,\n              <jats:sup>15<\/jats:sup>\n              N]\n              <jats:sc>l<\/jats:sc>\n              \u2010leucine to evaluate oxidative metabolism by gas chromatography\u2010mass spectroscopy and nuclear magnetic resonance methods.\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              improved survival, increased oxidative substrate contribution through pyruvate dehydrogenase, reduced succinate and fumarate accumulation, and ameliorated\n              <jats:styled-content style=\"fixed-case\">ATP<\/jats:styled-content>\n              depletion induced by ischemia. The functional and metabolic benefit of\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              was lost with weaning, yet triiodothyronine supplementation during ECMO restored function, increased relative\n              <jats:styled-content style=\"fixed-case\">pyruvate dehydrogenase<\/jats:styled-content>\n              flux, reduced succinate and fumarate, and preserved\n              <jats:styled-content style=\"fixed-case\">ATP<\/jats:styled-content>\n              stores.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Although\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              provides metabolic rest by decreasing energy demand, metabolic impairments persist, and are exacerbated with weaning. Treating\n              <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>\n              \u2010induced thyroid depression with triiodothyronine improves substrate flux, myocardial oxidative capacity and cardiac contractile function. This translational model suggests that metabolic targeting can improve weaning.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000680","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T00:48:01Z","timestamp":1395362881000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Triiodothyronine Facilitates Weaning From Extracorporeal Membrane Oxygenation by Improved Mitochondrial Substrate Utilization"],"prefix":"10.1161","volume":"3","author":[{"given":"Matthew D.","family":"Files","sequence":"first","affiliation":[{"name":"Department of Cardiology, Seattle Children's Hospital, Seattle, WA"},{"name":"Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Kajimoto","sequence":"additional","affiliation":[{"name":"Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen M.","family":"O'Kelly Priddy","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolena R.","family":"Ledee","sequence":"additional","affiliation":[{"name":"Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Xu","sequence":"additional","affiliation":[{"name":"Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Des Rosiers","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Universite de Montreal and Montreal Heart Institute, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Isern","sequence":"additional","affiliation":[{"name":"Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratories, Richland, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Portman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Seattle Children's Hospital, Seattle, WA"},{"name":"Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, 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