Association Between End-Tidal Carbon Dioxide and Pulmonary Artery Pulse Pressure During Veno-Arterial Extracorporeal Membrane Oxygenation with Impella®: A Retrospective Exploratory Study
4 affiliations
- 1Department of Clinical Engineering, Japanese Red Cross Musashino Hospital, Kyonan-cho 1-26-1, Musashino City 180-8610, Tokyo, Japan
- 2Emergency and Critical Care Center, Japanese Red Cross Musashino Hospital, Kyonan-cho 1-26-1, Musashino City 180-8610, Tokyo, Japan
- 3Intensive Care Unit, Japanese Red Cross Musashino Hospital, Kyonan-cho 1-26-1, Musashino City 180-8610, Tokyo, Japan
- 4Department of Thoracic Surgery, Japanese Red Cross Musashino Hospital, Kyonan-cho 1-26-1, Musashino City 180-8610, Tokyo, Japan
Abstract
Background: Assessment of native cardiopulmonary circulation is essential during combined veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella® support (ECPELLA). Pulmonary artery catheter (PAC)-derived pulmonary artery pulse pressure (PAPP) is associated with RV stroke volume and pulmonary arterial compliance; however, PAC monitoring has procedure-related risks and technical limitations. End-tidal carbon dioxide (EtCO2) is a simple, continuous, noninvasive indicator of pulmonary blood flow; however, its relationship with PAPP during ECPELLA support remains unclear. Methods: We retrospectively analyzed adult patients who underwent simultaneous ECPELLA and PAC monitoring between April 2024 and December 2025. Hemodynamic variables and EtCO2 were evaluated on ECPELLA support day 1 and on the final day of V-A ECMO support. Correlations between EtCO2 and PAPP, as well as their temporal changes during ECPELLA support, were assessed using Spearman correlation analysis. Results: Sixteen patients were included. EtCO2 showed significant positive correlations with PAPP on ECPELLA support day 1 (r = 0.63, p = 0.009), on the final day of V-A ECMO support (r = 0.67, p = 0.007), and for changes over time (ΔPAPP vs. ΔEtCO2, r = 0.76, p = 0.001). Conclusions: EtCO2 was associated with PAPP and its temporal changes during ECPELLA support. Although these findings suggest a potential role for EtCO2 in noninvasive assessment of PAPP trends, further studies in larger cohorts are needed to better characterize this relationship.
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BibTeX
@article{shimizu2026association,
title = {{Association Between End-Tidal Carbon Dioxide and Pulmonary Artery Pulse Pressure During Veno-Arterial Extracorporeal Membrane Oxygenation with Impella®: A Retrospective Exploratory Study}},
author = {Hayato Shimizu and Chikara Ishino and Tomoya Ota and Naohiro Seki and Shunsuke Suzuki and Eriko Gojo and Kohei Sakagami and Miho Nagai and Junji Kakizaki and Yuta Hirano and Ken Magata and Goji Shimizu and Manato Watanabe and Yusuke Kuwahara and Chihiro Kagohashi},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208070},
url = {https://www.mdpi.com/2077-0383/15/20/8070},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association Between End-Tidal Carbon Dioxide and Pulmonary Artery Pulse Pressure During Veno-Arterial Extracorporeal Membrane Oxygenation with Impella®: A Retrospective Exploratory Study
AU - Hayato Shimizu
AU - Chikara Ishino
AU - Tomoya Ota
AU - Naohiro Seki
AU - Shunsuke Suzuki
AU - Eriko Gojo
AU - Kohei Sakagami
AU - Miho Nagai
AU - Junji Kakizaki
AU - Yuta Hirano
AU - Ken Magata
AU - Goji Shimizu
AU - Manato Watanabe
AU - Yusuke Kuwahara
AU - Chihiro Kagohashi
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208070
UR - https://www.mdpi.com/2077-0383/15/20/8070
AB - Background: Assessment of native cardiopulmonary circulation is essential during combined veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella® support (ECPELLA). Pulmonary artery catheter (PAC)-derived pulmonary artery pulse pressure (PAPP) is associated with RV stroke volume and pulmonary arterial compliance; however, PAC monitoring has procedure-related risks and technical limitations. End-tidal carbon dioxide (EtCO2) is a simple, continuous, noninvasive indicator of pulmonary blood flow; however, its relationship with PAPP during ECPELLA support remains unclear. Methods: We retrospectively analyzed adult patients who underwent simultaneous ECPELLA and PAC monitoring between April 2024 and December 2025. Hemodynamic variables and EtCO2 were evaluated on ECPELLA support day 1 and on the final day of V-A ECMO support. Correlations between EtCO2 and PAPP, as well as their temporal changes during ECPELLA support, were assessed using Spearman correlation analysis. Results: Sixteen patients were included. EtCO2 showed significant positive correlations with PAPP on ECPELLA support day 1 (r = 0.63, p = 0.009), on the final day of V-A ECMO support (r = 0.67, p = 0.007), and for changes over time (ΔPAPP vs. ΔEtCO2, r = 0.76, p = 0.001). Conclusions: EtCO2 was associated with PAPP and its temporal changes during ECPELLA support. Although these findings suggest a potential role for EtCO2 in noninvasive assessment of PAPP trends, further studies in larger cohorts are needed to better characterize this relationship.
SN - 2077-0383
ER -