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Extracorporeal co2 removal

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https://www.readbyqxmd.com/read/29860680/rapid-onset-plasma-leakage-of-extracorporeal-oxygenation-membranes-possibly-due-to-hyperbilirubinemia
#1
Yoshiko Kida, Shinichiro Ohshimo, Michihito Kyo, Yuko Tanabe, Kei Suzuki, Koji Hosokawa, Nobuaki Shime
Extracorporeal membrane oxygenation (ECMO) is an emerging tool for supporting cardiopulmonary function in patients with cardiorespiratory failure or arrest. The oxygenator of the ECMO circuit requires effective oxygenation and removal of carbon dioxide from the blood. Major problems that can occur with the oxygenator include plasma leakage, one of the late-onset serious complications necessitating device replacement. However, the rapid onset of plasma leakage is rare. We present a 1-year-old boy with acute respiratory failure due to Pneumocystis and Aspergillus pneumonia...
June 2, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29796067/a-united-kingdom-register-study-of-in-hospital-outcomes-of-patients-receiving-extracorporeal-carbon-dioxide-removal
#2
Carole Cummins, Andrew Bentley, Daniel F McAuley, James J McNamee, Hannah Patrick, Nicholas A Barrett
Introduction: Extracorporeal membrane carbon dioxide removal may have a role in treatment of patients with hypercapnic respiratory failure and refractory hypoxaemia and/or hypercapnia. Methods: We report on the use, outcomes and complications in United Kingdom intensive care units reporting patients on the Extracorporal Life Support Organisation register. Results: Of 60 patients, 42 (70%) had primarily hypoxic respiratory failure and 18 (30%) primarily hypercapnic respiratory failure...
May 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29783879/effects-of-sodium-citrate-citric-acid-and-lactic-acid-on-human-blood-coagulation
#3
Vittorio Scaravilli, Luca Di Girolamo, Eleonora Scotti, Mattia Busana, Osvaldo Biancolilli, Patrizia Leonardi, Andrea Carlin, Caterina Lonati, Mauro Panigada, Antonio Pesenti, Alberto Zanella
INTRODUCTION: Citric acid infusion in extracorporeal blood may allow concurrent regional anticoagulation and enhancement of extracorporeal CO2 removal. Effects of citric acid on human blood thromboelastography and aggregometry have never been tested before. METHODS: In this in vitro study, citric acid, sodium citrate and lactic acid were added to venous blood from seven healthy donors, obtaining concentrations of 9 mEq/L, 12 mEq/L and 15 mEq/L. We measured gas analyses, ionized calcium (iCa++ ) concentration, activated clotting time (ACT), thromboelastography and multiplate aggregometry...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#4
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744220/principles-and-indications-of-extracorporeal-life-support-in-general-thoracic-surgery
#5
REVIEW
Karen McRae, Marc de Perrot
The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA® Novalung® , Heilbronn, Germany), and extracorporeal CO2 removal (ECCO2 R)...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29743094/feasibility-and-safety-of-low-flow-extracorporeal-co-2-removal-managed-with-a-renal-replacement-platform-to-enhance-lung-protective-ventilation-of-patients-with-mild-to-moderate-ards
#6
Matthieu Schmidt, Samir Jaber, Elie Zogheib, Thomas Godet, Gilles Capellier, Alain Combes
BACKGROUND: Extracorporeal carbon-dioxide removal (ECCO2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (Pplat ) (< 30 cmH2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS)...
May 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29732188/weaning-from-veno-venous-extracorporeal-membrane-oxygenation-how-i-do-it
#7
REVIEW
Lars M Broman, Maximilian V Malfertheiner, Andrea Montisci, Federico Pappalardo
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a rescue treatment for acute respiratory distress syndrome (ARDS) failing protective mechanical ventilation. It temporarily provides proper gas exchange: hypoxia is treated by adjusting the blood flow rate and fraction in spired oxygen over the ventilator (FiO2 ) on the extracorporeal membrane oxygenation (ECMO) circuit while CO2 removal is regulated by the ECMO fresh gas flow. Therefore, ventilator settings can be gradually reduced allowing the lungs to rest and recover...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732184/spontaneous-breathing-during-veno-venous-extracorporeal-membrane-oxygenation
#8
REVIEW
Stefania Crotti, Nicola Bottino, Elena Spinelli
Veno-venous extracorporeal membrane oxygenation (VV ECMO) has started to be applied in awake spontaneously breathing patients as an alternative to invasive mechanical ventilation. As the physiologic cardiorespiratory variability is increased in this condition, the dynamic interaction between patient respiratory activity and extracorporeal system function affects the clinical management. The effect of extracorporeal CO2 removal on patient respiratory drive is variable and not always predictable, with some patients responding to CO2 removal with a decrease in respiratory rate and effort and other patients demonstrating a persistently high work of breathing independent on CO2 unload...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732176/oxygenator-performance-and-artificial-native-lung-interaction
#9
REVIEW
Francesco Epis, Mirko Belliato
During extracorporeal membrane oxygenation (ECMO), oxygen (O2 ) transfer (V'O2 ) and carbon dioxide (CO2 ) removal (V'CO2 ) are partitioned between the native lung (NL) and the membrane lung (ML), related to the patient's metabolic-hemodynamic pattern. The ML could be assimilated to a NL both in a physiological and a pathological way. ML O2 transfer (V'O2 ML) is proportional to extracorporeal blood flow and the difference in O2 content between each ML side, while ML CO2 removal (V'CO2 ML) can be calculated from ML gas flow and CO2 concentration at sweep gas outlet...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29466596/acute-respiratory-distress-syndrome-advances-in-diagnosis-and-treatment
#10
REVIEW
Eddy Fan, Daniel Brodie, Arthur S Slutsky
Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually. Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years. Evidence Review: We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 2012 to 2017 focusing on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29461889/the-evolution-of-extracorporeal-membrane-oxygenation-for-adult-respiratory-failure
#11
Daniel Brodie
The use of extracorporeal membrane oxygenation to support patients with cardiac and respiratory failure has increased substantially in the last decade. Although the evidence base for its use in adults with respiratory failure is growing, many questions remain to be answered. Ongoing research is aimed at clarifying the role of extracorporeal membrane oxygenation, as well as extracorporeal carbon dioxide removal, in various forms of hypoxemic and hypercapnic respiratory failure, and at defining the optimal techniques for its use...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29434789/effects-of-pumpless-extracorporeal-lung-assist-on-hemodynamics-gas-exchange-and-inflammatory-cascade-response-during-experimental-lung-injury
#12
Zhihai Ju, Jinhui Ma, Chen Wang, Jie Yu, Yeru Qiao, Feilong Hei
Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29430448/extracorporeal-carbon-dioxide-removal-in-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#13
REVIEW
Tommaso Pettenuzzo, Eddy Fan, Lorenzo Del Sorbo
Extracorporeal carbon dioxide removal (ECCO2 R) has been proposed as an adjunctive intervention to avoid worsening respiratory acidosis, thereby preventing or shortening the duration of invasive mechanical ventilation (IMV) in patients with exacerbation of chronic obstructive pulmonary disease (COPD). This review will present a comprehensive summary of the pathophysiological rationale and clinical evidence of ECCO2 R in patients suffering from severe COPD exacerbations.
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29405675/patient-selection-for-extracorporeal-co2-removal-a-task-as-challenging-as-for-ecmo-therapy
#14
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
No abstract text is available yet for this article.
March 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29372630/what-can-we-apply-to-manage-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-acute-respiratory-failure
#15
REVIEW
Deog Kyeom Kim, Jungsil Lee, Ju Hee Park, Kwang Ha Yoo
Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics...
April 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29310404/extracorporeal-membrane-oxygenation-combined-with-continuous-renal-replacement-therapy-in-cutaneous-burn-and-inhalation-injury-caused-by-hydrofluoric-acid-and-nitric-acid
#16
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29302116/quantification-of-carbon-dioxide-removal-at-low-sweep-gas-and-blood-flows
#17
Juan de Villiers Hugo, Ajay S Sharma, Usaama Ahmed, Patrick W Weerwind
Advancement in oxygenator membrane technology has further expanded the boundaries in the clinical application of extracorporeal carbon dioxide removal (ECCO2 R). Despite the advent of modern poly-4-methyl-1-pentene (PMP) membranes, limited information exists on the performance of these membranes at low sweep gas and blood flows. Moreover, physiological relationships for CO2 removal at these flows are less explored. Hence, CO2 removal was quantified in an in vitro setting using a PMP membrane oxygenator. ECCO2 R was performed using a ...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29211496/reply-to-morales-quinteros-et-al-precision-medicine-for-extracorporeal-co-2-removal-for-acute-respiratory-distress-syndrome-co-2-physiological-considerations
#18
Ewan C Goligher, Marcelo B P Amato, Arthur S Slutsky
No abstract text is available yet for this article.
April 15, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29211495/precision-medicine-for-extracorporeal-co-2-removal-for-acute-respiratory-distress-syndrome-co-2-physiological-considerations
#19
Luis Morales-Quinteros, Antonio Artigas, David A Kaufman
No abstract text is available yet for this article.
April 15, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29179681/low-flow-extracorporeal-co-2-removal-in-ards-patients-a-prospective-short-term-crossover-pilot-study
#20
Harlinde Peperstraete, Sunny Eloot, Pieter Depuydt, Filip De Somer, Carl Roosens, Eric Hoste
BACKGROUND: Lung protective mechanical ventilation (MV) is the corner stone of therapy for ARDS. However, its use may be limited by respiratory acidosis. This study explored feasibility of, effectiveness and safety of low flow extracorporeal CO2 removal (ECCO2 R). METHODS: This was a prospective pilot study, using the Abylcap® (Bellco) ECCO2 R, with crossover off-on-off design (2-h blocks) under stable MV settings, and follow up till end of ECCO2 R. Primary endpoint for effectiveness was a 20% reduction of PaCO2 after the first 2-h...
November 28, 2017: BMC Anesthesiology
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