As shown in Figure 1, the experimental ECMO circuit was composed of the i-Cor system (Xenious AG, Heilbronn, Germany), including a console and an i-Cor diagonal pump, the Medos Hilite 2400LT membrane oxygenator (Medos Medizintechnik AG, Stolberg, Germany), and the ECMO tubing sets. The oxygen (O2)/airflow was maintained in the ranges of arterial partial pressure of oxygen (PaO2) from 10.0 kilopascal (kPa) to 16.0 kPa, and arterial partial pressure of carbon dioxide (PaCO2) from 4.0 kPa to 6.0 kPa, respectively, as suggested elsewhere.12 The blood flow rate was initiated at 1 liter/minute (L/min) before ECMO commencement. Switching of pulsatile or non-pulsatile flow can be done by the i-Cor system with a fixed blood flow rate. Adjustment of the pump rotation speed can be triggered by the electrocardiogram (ECG), according to which pulsatile flows were running in a parallel manner (1:1) on condition that heart rates stayed below 100 beats/min. Intravenous verapamil (1.5 mg) was used if tachycardia (heart rate higher than 120 beats/min) occurred to maintain the parallel pulsatile flow.

The investigated V-A ECMO circuits.

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