Mueller, Thomas and Lubnow, M. and Philipp, A. and Bein, T. and Jeron, A. and Luchner, A. and Rupprecht, L. and Reng, M. and Langgartner, J. and Wrede, C. E. and Zimmermann, M. and Birnbaum, D. and Schmid, C. and Riegger, G. A. J. and Pfeifer, M. (2009) Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy. EUROPEAN RESPIRATORY JOURNAL, 33 (3). pp. 551-558. ISSN 0903-1936,
Full text not available from this repository. (Request a copy)Abstract
Respiratory acidosis can become a serious problem during protective ventilation of severe lung failure. A pumpless arteriovenous interventional lung assist (iLA) for extracorporeal carbon dioxide removal has been used increasingly to control critical respiratory situations. The present study sought to evaluate the factors determining the efficacy of ILA and calculate its contribution to gas exchange. In a cohort of 96 patients with severe acute respiratory distress syndrome, haemodynamic parameters, oxygen consumption and carbon dioxide production as well as gas transfer through the ILA were analysed. The measurements demonstrated a significant dependency of blood flow via the ILA device on cannula size (mean +/- SD 1.59 +/- 0.52 L.min(-1) for 15 French (Fr), 1.94 +/- 0.35 L.min(-1) for 17 Fr, and 2.22 +/- 0.45 L.min(-1) for 19 Fr) and on mean arterial pressure. Oxygen transfer capacity averaged 41.7 +/- 20.8 mL.min(-1), carbon dioxide removal was 148.0 +/- 63.4 mL.min(-1). Within two hours of iLA treatment, arterial oxygen partial pressure/inspired oxygen fraction ratio increased significantly and a fast improvement in arterial carbon dioxide partial pressure and pH was observed. Interventional lung assist eliminates similar to 50% of calculated total carbon dioxide production with rapid normalisation of respiratory acidosis. Despite limited contribution to oxygen transfer it may allow a more protective ventilation in severe respiratory failure.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARBON-DIOXIDE REMOVAL; RESPIRATORY-DISTRESS-SYNDROME; ARTERIOVENOUS CO2 REMOVAL; CRITICALLY ILL PATIENTS; GAS-EXCHANGE; BLOOD-FLOW; FAILURE; OXYGENATION; SUPPORT; INJURY; Acute respiratory distress syndrome; extracorporeal carbon dioxide removal; interventional lung assist; oxygen transfer |
| 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 I Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 22 Sep 2020 10:15 |
| Last Modified: | 22 Sep 2020 10:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/29349 |
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