- Venous return – relevant factors, including measurement, estimation and mathematical modelling of meansystemic filling pressure
- Cardiopulmonary interactions
- Gas exchange in extracorporeal membrane oxygenation
- Development of methods to measure cardiac output and extensive cardiopulmonary monitoring duringextracorporeal oxygenation
- Mathematical monitoring of physiological systems
Understanding the pathophysiology of disease processes is essential to select and refine tools for monitoring andpredicting responses to therapy in critical care.
Our group focuses on the assessment of volume status, right ventricular function and gas exchange under extracorporealmembrane oxygenation. We use ECMO as a model to describe physiological mechanisms in cardiovascular dynamics,heart-lung interactions and venous return.
A particular interest lies in the development of monitoring and weaning strategies for safe and predictable de-escalation ofextracorporeal support. We aim to assess the cardiac output response during ECMO weaning using gas measurementsand adaptations of thermodilution techniques to to evaluate the response in cardiac output and right heart function.
Our available possibilities include, among others:
- ECMO therapy in the setting of sepsis and/or ARDS with and without native cardiac output
- High-resolution data recording of physiological signals in the cardiopulmonary system
- Heart catheterisation, including PV-Loop analysis
- Volumetric capnography and exhaled gas analysis
- Data analysis and modelling using MatLab™
Kaspar Bachmann, MD
Per Werner-Möller, MD, PhD
Andreas Bloch, MD
Stefan Blöchlinger, MD
Professor Matthias Hänggi, MD
- Our projects are regularly supported by doctoral and master students in medicine.
- Effects of positive and expiratory pressure on diastolic heart function in man
- Mathematical modelling of venous return
- Gas exchange during extracorporeal membrane oxygenation
- Measurement of cardiac output and evaluation of right heart function in extracorporeal circulation
- Modelling of gas exchange and its influence on the oxygen and carbon dioxide content of venous and arterial blood
- Assessment of right heart function during extracorporeal therapy by modified thermodilution in a porcine model. Bachmann KF, Zwicker L, Nettelbeck K, Casoni D, Heinisch PP, Jenni H, Haenggi M, Berger D. Anesthesiology. 2020 Oct 1;133(4):879-891.
- Gas exchange calculation may estimate changes in pulmonary blood flow during veno-arterial extracorporeal membrane oxygenation in a porcine model. Bachmann KF, Haenggi M, Jakob SM, Takala J, Gattinoni L, Berger D. Am J Physiol Lung Cell Mol Physiol. 2020 Jun 1;318(6):L1211-L1221.
- The effects of vasoconstriction and volume expansion on veno-arterial ECMO flow. Moller PW, Hana A, Heinisch PP, Liu S, Djafarzadeh S, Haenggi M, Bloch A, Takala J, Jakob SM, Berger D. Shock. 2019 May;51(5):650-658.
- Effect of volume status on the estimation of mean systemic filling pressure. Moller PW, Sondergaard S, Jakob SM, Takala J, Berger D. J Appl Physiol (1985). 2019 Jun 1; 126(6):1503-1513.
- Determinants of systemic venous return and the impact of positive pressure ventilation. Berger D, Takala J. Ann Transl Med. 2018 Sep;6(18):350.
- Right atrial pressure and venous return during cardiopulmonary bypass. Moller PW, Winkler B, Hurni S, Heinisch PP, Bloch A, Sondergaard S, Jakob SM, Takala J, Berger D. Am J Physiol Heart Circ Physiol. 2017 Aug 1;313(2):H408-H420.
- Basic concepts of heart-lung interactions during mechanical ventilation. Grübler MR, Wigger O, Berger D, Bloechlinger S. Swiss Med Wkly. 2017 Sep 12;147:w14491.
- Effect of PEEP, blood volume, and inspiratory hold maneuvers on venous return. Berger D, Moller PW, Weber A , Bloch A, Bloechlinger S, Haenggi M, Sondergaard S, Jakob SM, Magder S, Takala J. Am J Physiol Heart Circ Physiol. 2016 Sep 1;311(3):H794-806.
- Dysfunction of respiratory muscles in critically ill patients on the intensive care unit. Berger D, Bloechlinger S, von Haehling S, Doehner W, Takala J, Z’Graggen WJ, Schefold JC. J Cachexia Sarcopenia Muscle. 2016 Sep;7(4):403-12.
- Heart-lung interactions during neurally adjusted ventilatory assist. Berger D, Bloechlinger S, Takala J, Sinderby C, Brander L. Crit Care. 2014 Sep 12;18(5):499.
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital
(A. Vogt, MD)
- Department of Anaesthesiology, Göttingen University, Germany (Prof. L. Gattinoni, MD)
- McGill University Health Centre, Department of Critical Care and Department of Physiology, Montreal, Quebec,Canada (Prof. S. Magder, MD)