• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

The Effect Of Tilt On Flow And Pressures In A Miniaturized Extracorporeal Life Support System

Hilary B Loge, MD1, Ryan Schutter, MD2, Brian J Gavitt, MD, MPH1, Jeremy Cannon, MD3, J Kevin Grayson, DVM, PhD1, B. Zane Atkins, MD, FACS1. 1Travis AFB, 2McConnell AFB, 3Ft Sam Houston

Objectives: Wounded warriors with severe lung injuries are currently being transported out of theater on extracorporeal life support (ECLS) via fixed-wing aircraft. There has been no systematic evaluation of the effects of in-flight patient position changes on circuit flows and pressures or on patient hemodynamics during transport. The first step in evaluation is to determine the effects of head up and head down tilt, simulating the angles of takeoff and landing, on the ECLS circuit and patient.

Methods: Swine were placed on the CardioHelpTM ECLS system, which is a miniaturized pump and circuit ideal for transport. Animals were placed in both a 15 degrees head up and 15 degrees head down position for periods of 30 minutes with a neutral period in between. Hemodynamics as well as circuit flow and pressures were recorded and compared to baseline.

Results: Cardiac output was significantly increased in both the head up (7.1 ± 0.2 L/min, p = 0.002) and head down positions (6.5 ± 0.3 L/min, p = 0.01) compared to neutral (5.5 ± 0.2 L/min).  Stroke volume was significantly increased in the head up position (71.6 ± 2.4 mL, p = 0.014) but not in the head down position (65.5 ± 4.0 mL, p = 0.07) compared to neutral (57.3 ± 4.0 mL). Venous drainage pressure in the ECLS circuit was significantly decreased in the head up position (-28.0 ± 1.5 mm Hg) compared to both neutral (-36.5 ± 2.2 mm Hg, p = 0.005) and head down (-33.3 ± 1.6 mm Hg, p = 0.027) positions.

Conclusion: Animals maintained their cardiac output while tilted. In fact, cardiac output increased in both the head up and head down positions. This suggests that patient positioning in an aircraft while on ECLS does not alter hemodynamics or circuit parameters during takeoff and landing. These findings also suggest that patient positioning for physical therapy and rehabilitation is safe while on ECLS support.

41

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube
  • Instagram
  • TikTok

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons