Mueller, Thomas and Philipp, Alois and Luchner, Andreas and Karagiannidis, Christian and Bein, Thomas and Hilker, Michael and Rupprecht, Leopold and Langgartner, Julia and Zimmermann, Markus and Arlt, Matthias and Wenger, Jan and Schmid, Christof and Riegger, Guenter A. J. and Pfeifer, Michael and Lubnow, Matthias (2009) A new miniaturized system for extracorporeal membrane oxygenation in adult respiratory failure. CRITICAL CARE, 13 (6): R205. ISSN 1466-609X,
Full text not available from this repository. (Request a copy)Abstract
Introduction Mortality of severe acute respiratory distress syndrome in adults is still unacceptably high. Extracorporeal membrane oxygenation (ECMO) could represent an important treatment option, if complications were reduced by new technical developments. Methods Efficiency, side effects and outcome of treatment with a new miniaturized device for veno-venous extracorporeal gas transfer were analysed in 60 consecutive patients with life-threatening respiratory failure. Results A rapid increase of partial pressure of arterial oxygen/fraction of inspired oxygen (PaO(2)/FiO(2)) from 64 (48 to 86) mmHg to 120 (84 to 171) mmHg and a decrease of PaCO(2) from 63 (50 to 80) mmHg to 33 (29 to 39) mmHg were observed after start of the extracorporeal support (P < 0.001). Gas exchange capacity of the device averaged 155 (116 to 182) mL/min for oxygen and 210 (164 to 251) mL/min for carbon dioxide. Ventilatory parameters were reduced to a highly protective mode, allowing a fast reduction of tidal volume from 495 (401 to 570) mL to 336 (292 to 404) mL (P < 0.001) and of peak inspiratory pressure from 36 (32 to 40) cmH(2)O to 31 (28 to 35) cmH(2)O (P < 0.001). Transfusion requirements averaged 0.8 (0.4 to 1.8) units of red blood cells per day. Sixty-two percent of patients were weaned from the extracorporeal system, and 45% survived to discharge. Conclusions Veno-venous extracorporeal membrane oxygenation with a new miniaturized device supports gas transfer effectively, allows for highly protective ventilation and is very reliable. Modern ECMO technology extends treatment opportunities in severe lung failure.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE LUNG INJURY; INTENSIVE-CARE UNITS; DISTRESS-SYNDROME; CLINICAL-TRIAL; LIFE-SUPPORT; TRANSFUSION REQUIREMENTS; BLOOD-TRANSFUSION; CRITICALLY-ILL; HIGH SURVIVAL; CO2 REMOVAL; |
| 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: | 12 Oct 2020 07:09 |
| Last Modified: | 12 Oct 2020 07:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/29700 |
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