Combes, Alain and Fanelli, Vito and Pham, Tai and Ranieri, V. Marco and Goligher, Ewan C. and Brodie, Daniel and Pesenti, Antonio and Beale, Richard and Brochard, Laurent and Chiche, Jean-Daniel and Fan, Eddy and de Backer, Daniel and Francois, Guy and Ferguson, Niall and Laffey, John and Mercat, Alain and McAuley, Daniel F. and Mueller, Thomas and Quintel, Michael and Vincent, Jean-Louis and Taccone, Fabio Silvio and Peperstraete, Harlinde and Morimont, Philippe and Schmidt, Matthieu and Levy, Bruno and Diehl, Jean-Luc and Guervilly, Christophe and Capelier, Gilles and Vieillard-Baron, Antoine and Messika, Jonathan and Karagiannidis, Christian and Moerer, Onnen and Urbino, Rosario and Antonelli, Massimo and Mojoli, Francesco and Alessandri, Francesco and Grasselli, Giacomo and Donker, Dirk and Ferrer, Ricard and Mancebo, Jordi and Slutsky, Arthur S. (2019) Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study. INTENSIVE CARE MEDICINE, 45 (5). pp. 592-600. ISSN 0342-4642, 1432-1238
Full text not available from this repository. (Request a copy)Abstract
PurposeWe assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (V-T 4mL/kg and P(PLAT)25cmH(2)O) in patients with moderate acute respiratory distress syndrome (ARDS).MethodsProspective multicenter international phase 2 study. Primary endpoint was the proportion of patients achieving ultra-protective ventilation with PaCO2 not increasing more than 20% from baseline, and arterial pH>7.30. Severe adverse events (SAE) and ECCO2R-related adverse events (ECCO2R-AE) were reported to an independent data and safety monitoring board. We used lower CO2 extraction and higher CO2 extraction devices (membrane lung cross-sectional area 0.59 vs. 1.30m(2); flow 300-500mL/min vs. 800-1000mL/min, respectively).ResultsNinety-five patients were enrolled. The proportion of patients who achieved ultra-protective settings by 8h and 24h was 78% (74 out of 95 patients; 95% confidence interval 68-89%) and 82% (78 out of 95 patients; 95% confidence interval 76-88%), respectively. ECCO2R was maintained for 5 [3-8]days. Six SAEs were reported; two of them were attributed to ECCO2R (brain hemorrhage and pneumothorax). ECCO2R-AEs were reported in 39% of the patients. A total of 69 patients (73%) were alive at day 28. Fifty-nine patients (62%) were alive at hospital discharge.ConclusionsUse of ECCO2R to facilitate ultra-protective ventilation was feasible. A randomized clinical trial is required to assess the overall benefits and harms.Clinicaltrials.govNCT02282657
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LUNG INJURY; 6 ML/KG; HYPERCAPNIA; PRESSURE; ECCO2R; Acute respiratory distress syndrome; Mechanical ventilation; Extracorporeal carbon dioxide removal; Ventilator-induced lung injury |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2020 07:25 |
| Last Modified: | 09 Apr 2020 07:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27099 |
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