Lubnow, Matthias and Luchner, Andreas and Philipp, Alois and Buchner, Stefan and Jeron, Andreas and Karagiannidis, Christian and Bein, Thomas and Pawlik, Michael and Jungbauer, Carsten and Schmid, Christof and Riegger, Guenter A. J. and Pfeifer, Michael and Mueller, Thomas (2010) Combination of high frequency oscillatory ventilation and interventional lung assist in severe acute respiratory distress syndrome. JOURNAL OF CRITICAL CARE, 25 (3). pp. 436-444. ISSN 0883-9441,
Full text not available from this repository. (Request a copy)Abstract
Background: The combination of high-frequency oscillatory ventilation (HFOV) and extracorporeal carbon dioxide removal with the interventional lung assist (iLA) in severe acute respiratory distress syndrome (ARDS) represents a novel treatment option. Methods: The study used a retrospective single-center analysis of 21 consecutive adult patients with severe ARDS, ventilated with HFOV/iLA. Efficiency, side effects, and outcome of combined treatment are presented as median (interquartile range). Measurements and Main Results: The following were used to determine patient characteristics: sequential organ failure assessment score, 14; simplified acute physiology score II, 41; and Murray score, 4. The duration of combined treatment was 6 days. The blood flow through the iLA was 1.9 L/min. The Pao(2)/inspired fraction of oxygen ratio increased from 61(47-86) to 98 (67-116) within 2 hours and to 106 (70-135) mm Hg at 24 hours. Paco(2) decreased from 58 (50-76) to 37 (29-47) mm Hg at 2 hours with normalization of pH 7.28 (7.16-7.36) to 7.43 (7.33-7.49) after 2 hours associated with hemodynamic stabilization. In 6 patients, complications due to iLA treatment were observed, and in 3 patients, complications associated with HFOV were seen. Weaning from HFOV/iLA was successful in 10 patients. The 30-day mortality rate was 43%, and hospital mortality rate was 57%. Conclusion: The combination of HFOV/iLA is an option in severe pulmonary failure if conventional ventilation fails and pumpdriven extracorporeal membrane oxygenation therapy is not available. (C) 2010 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ADULT PATIENTS; MECHANICAL VENTILATION; INJURY; DETERMINANTS; EXPERIENCE; MORTALITY; FAILURE; ARDS; Carbon dioxide removal; HFOV; High-frequency oscillatory ventilation; iLA; Interventional lung assist |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jul 2020 06:04 |
| Last Modified: | 15 Jul 2020 06:04 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24256 |
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