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Practical Clinical Application of an Extracorporeal Carbon Dioxide Removal System in Acute Respiratory Distress Syndrome and Acute on Chronic Respiratory Failure
- Source :
- ASAIO journal (American Society for Artificial Internal Organs : 1992). 66(6)
- Publication Year :
- 2019
-
Abstract
- We retrospectively reviewed the medical records of 11 patients supported with a veno-venous low-flow extracorporeal carbon dioxide (CO2) removal (ECCO2R) device featuring a large gas exchange surface membrane lung (ML) (i.e., 1.8 m). Seven patients suffered from exacerbation of a chronic pulmonary disease, while four subjects were affected by acute respiratory distress syndrome (ARDS). Twenty-four hours of ECCO2R treatment reduced arterial PCO2 from 63 ± 12 to 54 ± 11 mm Hg (p < 0.01), increased arterial pH from 7.29 ± 0.07 to 7.39 ± 0.06 (p < 0.01), and decreased respiratory rate from 32 ± 10 to 21 ± 8 bpm (p < 0.05). Extracorporeal blood flow and CO2 removal were 333 ± 37 and 94 ± 18 ml/min, respectively. The median duration of ECCO2R treatment was 7 days (6.5-9.5). All four ARDS patients were invasively ventilated at the time of treatment start, no one was extubated and they all died. Among the seven patients with exacerbation of chronic pulmonary diseases, four were managed with noninvasive ventilation at ECCO2R institution, while three were extubated after starting the extracorporeal treatment. No one of these seven patients was intubated or re-intubated after ECCO2R institution and five (71%) survived to hospital discharge. A low-flow ECCO2R device with a large surface ML removes a relevant amount of CO2 resulting in a decreased arterial PCO2, an increased arterial pH, and in a reduced ventilatory load.
- Subjects :
- Male
ARDS
Extracorporeal Circulation
Exacerbation
medicine.medical_treatment
Biomedical Engineering
Biophysics
Bioengineering
Acute respiratory distress
030204 cardiovascular system & hematology
Extracorporeal
Biomaterials
Extracorporeal carbon dioxide removal
03 medical and health sciences
0302 clinical medicine
medicine
Extracorporeal membrane oxygenation
Humans
Aged
Retrospective Studies
Respiratory Distress Syndrome
Lung
business.industry
General Medicine
Blood flow
Carbon Dioxide
Middle Aged
medicine.disease
medicine.anatomical_structure
030228 respiratory system
Anesthesia
Female
business
Respiratory Insufficiency
Subjects
Details
- ISSN :
- 1538943X
- Volume :
- 66
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- ASAIO journal (American Society for Artificial Internal Organs : 1992)
- Accession number :
- edsair.doi.dedup.....675fe10ea33d0fc6337d89e5d92c28d6