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Extracorporeal co2 removal

Pablo Tapia, Felipe Lillo, Dagoberto Soto, Leslie Escobar, Felipe Simon, Karina Hernández, Leyla Alegría, Alejandro Bruhn
A promising approach to facilitate protective mechanical ventilation is the use of extracorporeal CO2 removal techniques. Several strategies based on membrane gas exchangers have been developed. However, these techniques are still poorly available. The goal of this study was to assess the efficacy and safety of THAM infusion coupled to hemofiltration for the management of hypercapnic acidosis. A severe respiratory acidosis was induced in seven anesthetized pigs. Five of them were treated with THAM 8-mmol·kg(-1)·h(-1) coupled to hemofiltration (THAM+HF group) at 100 mL·kg(-1)·h(-1)...
2016: American Journal of Translational Research
Mirko Belliato, Antonella Degani, Antonino Buffa, Fabio Sciutti, Michele Pagani, Carlo Pellegrini, Giorgio Antonio Iotti
Monitoring veno-venous extracorporeal membrane oxygenation (vvECMO) during 76 days of continuous support in a 42-years old patient with end-stage pulmonary disease, listed for double-lung transplantation. Applying a new monitor (Landing(®), Eurosets, Medolla, Italy) and describing how measured and calculated parameters can be used to understand the variable interdependency between artificial membrane lung (ML) and patient native lung (NL). During vvECMO, in order to understand how the respiratory function is shared between ML and NL, ideally we should obtain data about oxygen transfer and CO2 removal, both by ML and NL...
August 24, 2016: Journal of Clinical Monitoring and Computing
Andrea Vianello, Giovanna Arcaro, Luciana Paladini, Silvia Iovino
Patients with Idiopathic Pulmonary Fibrosis (IPF) requiring Invasive Mechanical Ventilation (IMV) following unsuccessful treatment with Non-Invasive Ventilation (NIV) have a high mortality rate. IMV is, moreover, an independent predictor of poor outcome during the post-transplantation period in patients on waiting lists for Lung Transplantation (LT). Here we describe the successful management of an IPF patient with acute respiratory failure (ARF) using a pump-assisted veno-venous system for extracorporeal CO2 removal (ECCO2R) (ProLUNG® system) as an alternative to endotracheal intubation (ETI) following NIV failure...
2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
John M Trahanas, William R Lynch, Robert H Bartlett
In the past the only option for the treatment of respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (aeCOPD) was invasive mechanical ventilation. In recent decades, the potential for extracorporeal carbon dioxide (CO2) removal has been realized. We review the various types of extracorporeal CO2 removal, outline the optimal use of these therapies for aeCOPD, and make suggestions for future controlled trials. We also describe the advantages and requirements for an ideal long-term ambulatory CO2 removal system for palliation of COPD...
August 10, 2016: Journal of Intensive Care Medicine
Bassam Redwan, Stephan Ziegeler, Michael Semik, Joachim Fichter, Nicolas Dickgreber, Volker Vieth, Erik Christian Ernst, Stefan Fischer
Lung volume reduction surgery (LVRS) is an important treatment option for end-stage lung emphysema in carefully selected patients. Here, we first describe the application of low-flow v-v extracorporeal CO2 removal (LFVV-ECCO2R) as bridge to LVRS in patients with end-stage lung emphysema experiencing severe hypercapnia due to acute failure of the breathing pump.Between March and October 2015, n = 4 patients received single-site LFVV-ECCO2R as bridge to LVRS.Indication for ECLS was severe hypercapnia with respiratory acidosis and acute breathing pump failure...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Stephan Braune, Annekatrin Sieweke, Franz Brettner, Thomas Staudinger, Michael Joannidis, Serge Verbrugge, Daniel Frings, Axel Nierhaus, Karl Wegscheider, Stefan Kluge
INTRODUCTION: The aim of the study was to evaluate the feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure refractory to noninvasive ventilation (NIV). METHODS: Case-control study. Patients with acute hypercapnic respiratory failure refractory to NIV being treated with a pump-driven veno-venous ECCO2R system (iLA-Activve(®); Novalung, Heilbronn, Germany) were prospectively observed in five European intensive care units (ICU)...
September 2016: Intensive Care Medicine
Stéphane Collaud, Christian Benden, Christoph Ganter, Sven Hillinger, Isabelle Opitz, Didier Schneiter, Reto Schuepbach, Ilhan Inci, Walter Weder
BACKGROUND: Extracorporeal life support (ECLS) as a bridge to lung retransplantation has been reported only anecdotally. Thus, we analyzed combined data from our center with pooled data from published studies to identify selection criteria for this advanced therapy. METHODS: Four patients at our center were bridged on ECLS to lung retransplantation. Patient data were retrospectively retrieved from electronic records. The MEDLINE database was searched using the PubMed engine and yielded 13 relevant studies that included a minimum of 3 patients bridged to lung retransplantation, and four studies described detailed data on 17 patients...
July 14, 2016: Annals of Thoracic Surgery
Martin Dres, Jordi Mancebo, Gerard F Curley
This review documents important progress made in 2015 in the field of critical care. Significant advances in 2015 included further evidence for early implementation of low tidal volume ventilation as well as new insights into the role of open lung biopsy, diaphragmatic dysfunction, and a potential mechanism for ventilator-induced fibroproliferation. New therapies, including a novel low-flow extracorporeal CO2 removal technique and mesenchymal stem cell-derived microparticles, have also been studied. Several studies examining the role of improved diagnosis and prevention of ventilator-associated pneumonia also showed relevant results...
July 1, 2016: American Journal of Respiratory and Critical Care Medicine
A Morelli, A D'Egidio, A Orecchioni, F Alessandri, L Mascia, V M Ranieri
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
F J Parrilla, L Bergesio, H Aguirre-Bermeo, J C Suarez, P López, I Morán, J Mancebo
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
P Ngasseu, J P Ponthus, V Amilien, M Tchir, J F Georger
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
A Zanella, D Ferlicca, S Abd El Aziz El Sayed Deab, S Colombo, S Spina, S Sosio, M Introna, D Ceriani, D Salerno, A Pesenti
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Zulian Liu, Rui V Duarte, Sue Bayliss, George Bramley, Carole Cummins
BACKGROUND: The extracorporeal membrane carbon dioxide removal (ECCO2R) system is primarily designed for the purpose of removing CO2 from the body for patients with potentially reversible severe acute hypercapnic respiratory failure or being considered for lung transplantation. Systematic reviews have focused on the effectiveness of ECCO2R. To the author's best knowledge, this is the first systematic review to focus on the adverse effects of this procedure. METHODS: We will conduct a systematic review of procedure-related adverse effects of ECCO2R systems...
2016: Systematic Reviews
Fulsen Bozkuş, Bora Bilal, Hafize Öksüz
The use of invasive mechanical ventilation (IMV) procedures in chronic obstructive pulmonary disease (COPD) patients suffering from episodes of acute exacerbation are associated with high rates of mortality. In this case study, we describe the use of a new device for extracorporeal carbon dioxide removal (ECCO2R) that can provide partial respiratory support for patients where noninvasive ventilation (NIV) proved insufficient. The case described in this manuscript represents the first clinical feasibility study for the Hemolung device, and was also the first use and application of the device at our department...
March 2016: Tüberküloz Ve Toraks
Caroline E Moss, Eleanor J Galtrey, Luigi Camporota, Chris Meadows, Stuart Gillon, Nicholas Ioannou, Nicholas A Barrett
We aimed to describe the use of venovenous extracorporeal carbon dioxide removal (ECCO2R) in patients with hypercapnic respiratory failure. We performed a retrospective case note review of patients admitted to our tertiary regional intensive care unit and commenced on ECCO2R from August 2013 to February 2015. Fourteen patients received ECCO2R. Demographic data, physiologic data (including pH and partial pressure of carbon dioxide in arterial blood [PaCO2]) when starting ECCO2R (t = 0), at 4 hourly intervals for the first 24 hours, then at 24 hour intervals until cessation of ECCO2R, and overall outcome were recorded...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jeremie Reeb, Anne Olland, Stephane Renaud, Anne Lejay, Nicola Santelmo, Gilbert Massard, Pierre-Emmanuel Falcoz
In thoracic surgery, extracorporeal life support (ECLS) techniques are performed to (I) provide a short to mid term extracorporeal mechanical support; (II) realize the gas exchanges; and (III)-depending the configuration of the circuit-substitute the failed heart function. The objective of this review is to describe the rational of the different ECLS techniques used in thoracic surgery and lung transplantation (LTx) with a specific attention to the vascular access. Venovenous extracorporeal membrane oxygenation (VV ECMO) is the most common ECLS technique used in thoracic surgery and represents the best strategy to support the lung function...
April 2016: Journal of Thoracic Disease
Hany Hazfiza Manap, Ahmad Khairi Abdul Wahab
The implementation of extracorporeal carbon dioxide removal (ECCO2R) as one of the extracorporeal life support system is getting more attention today. Thus, the objectives of this paper are to study the clinical practice of commercial ECCO2R system, current trend of its development and also the perspective on future improvement that can be done to the existing ECCO2R system. The strength of this article lies in its review scope, which focuses on the commercial ECCO2R therapy in the market based on membrane lung and current investigation to improve the efficiency of the ECCO2R system, in terms of surface modification by carbonic anhydrase (CA) immobilization technique and respiratory electrodialysis (R-ED)...
May 18, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Luciano Gattinoni
Partial extracorporeal CO2 removal allows a decreasing tidal volume without respiratory acidosis in patients with acute respiratory distress syndrome. This, however, may be associated with worsening hypoxemia, due to several mechanisms, such as gravitational and reabsorption atelectasis, due to a decrease in mean airway pressure and a critically low ventilation-perfusion ratio, respectively. In addition, an imbalance between alveolar and artificial lung partial pressures of nitrogen may accelerate the process...
2016: Critical Care: the Official Journal of the Critical Care Forum
Andrea Dell'Amore, Rocco D'Andrea, Guido Caroli, Carlo Alberto Mazzoli, Alberto Rocca, Franco Stella, Alessandro Bini, Rita Melotti
Extracorporeal CO2-removal devices have been introduced in clinical practice to provide protective and ultraprotective ventilation strategies in different settings to avoid retention of carbon dioxide. The need to facilitate lung-protective ventilation is required not only for the treatment of acute respiratory distress syndrome but also in thoracic surgery during complex operations, especially in respiratory compromised patients. This report describes a case of giant bullectomy for vanishing lung syndrome in which intraoperative hypercapnia secondary to protective ventilation was managed with a CO2-removal device (Decap-Hemodec s...
March 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Xufeng Wei, Pablo G Sanchez, Yang Liu, A Claire Watkins, Tieluo Li, Bartley P Griffith, Zhongjun J Wu
Respiratory failure is one of the major causes of mortality and morbidity all over the world. Therapeutic options to treat respiratory failure remain limited. The objective of this study was to evaluate the gas transfer performance of a newly developed miniature portable integrated pediatric pump-lung device (PediPL) with small membrane surface for respiratory support in an acute ovine respiratory failure model. The respiratory failure was created in six adult sheep using intravenous anesthesia and reduced mechanical ventilation at 2 breaths/min...
April 18, 2016: Artificial Organs
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