Lehle, Karla and Philipp, Alois and Hiller, Karl-Anton and Zeman, Florian and Buchwald, Dirk and Schmid, Christof and Dornia, Christian and Lunz, Dirk and Mueller, Thomas and Lubnow, Matthias (2014) Efficiency of gas transfer in venovenous extracorporeal membrane oxygenation: analysis of 317 cases with four different ECMO systems. INTENSIVE CARE MEDICINE, 40 (12). pp. 1870-1877. ISSN 0342-4642, 1432-1238
Full text not available from this repository. (Request a copy)Abstract
Polymethylpentene membrane oxygenators used in venovenous extracorporeal membrane oxygenation (vvECMO) differ in their physical characteristics. The aim of the study was to analyze the gas transfer capability of different ECMO systems in clinical practice, as the choice of the appropriate system may be influenced by the needs of the patient. Retrospective study on prospectively collected data of adults with severe respiratory failure requiring vvECMO support (Regensburg ECMO Registry, 2009-2013). Oxygen (O-2) transfer and carbon dioxide (CO2) elimination of four different ECMO systems (PLS system, n = 163; Cardiohelp system (CH), n = 59, Maquet Cardiopulmonary, Rastatt, Germany; Hilite 7000 LT system, n = 56, Medos Medizintechnik, Stolberg, Germany; ECC.05 system, n = 39, Sorin Group, Mirandola (MO), Italy) were analyzed. Gas transfer depended on type of ECMO system, blood flow, and gas flow (p a parts per thousand currency sign 0.05, each). CO2 removal is dependent on sweep gas flow and blood flow, with higher blood flow and/or gas flow eliminating more CO2 (p a parts per thousand currency sign 0.001). CO2 elimination capacity was highest with the PLS system (p a parts per thousand currency sign 0.001). O-2 transfer at blood flow rates below 3 l/min depended on blood flow, at higher blood flow rates on blood flow and gas flow. The system with the smallest gas exchange surface (ECC.05 system) was least effective in O-2 transfer, but in terms of the gas exchange surface was the most effective. Our analysis suggests that patients with severe hypoxemia and need for high flow ECMO benefit more from the PLS/CH or Hilite 7000 LT system. The ECC.05 system is advisable for patients with moderate hypoxemia and/or hypercapnia.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POLYMETHYLPENTENE OXYGENATOR; LIFE-SUPPORT; EXPERIENCE; FAILURE; DEVICE; ECMO; Gas transfer; PMP oxygenator; CO2 removal; O-2 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 II Medicine > Lehrstuhl für Röntgendiagnostik Medicine > Lehrstuhl für Zahnerhaltung und Parodontologie > Dr. rer. nat. Karl-Anton Hiller Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Aug 2019 09:29 |
| Last Modified: | 07 Aug 2019 09:29 |
| URI: | https://pred.uni-regensburg.de/id/eprint/9146 |
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