The impact of hypovolemia and PEEP on recirculation in venovenous ECMO: an experimental porcine model.

Background: Recirculation is a common problem in venovenous extracorporeal membrane oxygenation (VV ECMO) and may limit the effect of ECMO treatment due to less efficient blood oxygenation or unfavorable ECMO and ventilator settings. The impact of hypovolemia and positive end expiratory pressure (PEEP) on recirculation is unclear and poorly described in guidelines, despite clinical importance. The aim of this study was to investigate how hypovolemia, autotransfusion and PEEP affect recirculation in comparison to ECMO cannula distance and circuit flow.

A pregnant woman in her thirties with abdominal pain, seizures and haemorrhagic shock.

A pregnant woman at term was admitted to the emergency department with abdominal pain, generalised seizures and haemorrhagic shock. An outpatient check-up five days earlier showed good general condition, normal blood pressure and normal fetal heartbeat.

Evaluation of fluid responsiveness: is photoplethysmography a noninvasive alternative?

Background. Goal-directed fluid therapy reduces morbidity and mortality in various clinical settings. Respiratory variations in photoplethysmography are proposed as a noninvasive alternative to predict fluid responsiveness during mechanical ventilation.