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Extracorporeal co2 removal

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https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#1
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#2
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#3
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27896375/-extracorporeal-co2-removal-as-an-alternative-to-tracheotomy-in-a%C3%A2-patient-with-extubation-failure
#4
A Redel, M Ritzka, S Kraus, A Philipp, H-J Schlitt, B Graf, T Bein
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours...
November 28, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27875410/should-we-use-driving-pressure-to-set-tidal-volume
#5
Domenico L Grieco, Lu Chen, Martin Dres, Laurent Brochard
PURPOSE OF REVIEW: Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CRS) is mostly affected by the volume of the baby lung, the ratio VT/CRS (i.e. the driving pressure, ΔP) may potentially help tailoring interventions on VT setting. RECENT FINDINGS: Driving pressure is the ventilatory variable most strongly associated with changes in survival and has been shown to be the key mediator of the effects of mechanical ventilation on outcome in the acute respiratory distress syndrome...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27873331/low-tidal-volume-reduces-lung-inflammation-induced-by-liquid-ventilation-in-piglets-with-severe-lung-injury
#6
Lijun Jiang, Huizhen Feng, Xiaofan Chen, Kaifeng Liang, Chengyao Ni
Total liquid ventilation (TLV) is an alternative treatment for severe lung injury. High tidal volume is usually required for TLV to maintain adequate CO2 clearance. However, high tidal volume may cause alveolar barotrauma. We aim to investigate the effect of low tidal volume on pulmonary inflammation in piglets with lung injury and under TLV. After the establishment of acute lung injury model by infusing lipopolysaccharide, 12 piglets were randomly divided into two groups, TLV with high tidal volume (25 mL/kg) or with low tidal volume (6 mL/kg) for 240 min, respectively...
November 21, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27842755/extracorporeal-gas-exchange-the-expanding-role-of-extracorporeal-support-in-respiratory-failure
#7
REVIEW
Nikunj Bhatt, Erik Osborn
The use of extracorporeal support is expanding quickly in adult respiratory failure. Extracorporeal gas exchange is an accepted rescue therapy for severe acute respiratory distress syndrome (ARDS) in select patients. Extracorporeal carbon dioxide removal is also being investigated as a preventative, preemptive, and management platform in patients with respiratory failure other than severe ARDS. The non-ARDS patient population is much larger, so the potential for rapid growth is high. This article hopes to inform decisions about the use of extracorporeal support by increasing understanding concerning the past and present practice of extracorporeal gas exchange...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27836209/-extracorporeal-co2-removal-as-life-support-system-for-a-severe-organizing-pneumonia
#8
G Rival, O Millet, G Capellier
INTRODUCTION: Acute lung injuries are usually found in intensive care unit. The diffuse alveolar damage (DAD) is the associated histological pattern and the most severe end-stage of the disease. Organizing pneumonia (OP), for which corticosteroids are the reference therapy, can mimic DAD. While postponing the response to treatment, to limit mechanical ventilation side effects, extracorporeal membrane oxygene can be proposed. We present a case of a severe OP for which extracorporeal CO2 removal (ECCO2R) is used as a bridge to recovery under corticosteroid therapy...
November 8, 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27648139/liquid-extracorporeal-carbon-dioxide-removal-use-of-tham-tris-hydroxymethyl-aminomethane-coupled-to-hemofiltration-to-control-hypercapnic-acidosis-in-a-porcine-model-of-protective-mechanical-ventilation
#9
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
https://www.readbyqxmd.com/read/27558734/a-brief-clinical-case-of-monitoring-of-oxygenator-performance-and-patient-machine-interdependency-during-prolonged-veno-venous-extracorporeal-membrane-oxygenation
#10
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
https://www.readbyqxmd.com/read/27537725/successful-management-of-acute-respiratory-failure-in-an-idiopathic-pulmonary-fibrosis-patient-using-an-extracorporeal-carbon-dioxide-removal-system
#11
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
https://www.readbyqxmd.com/read/27509917/extracorporeal-support-for-chronic-obstructive-pulmonary-disease-a-bright-future
#12
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
https://www.readbyqxmd.com/read/27465095/single-site-cannulation-veno-venous-extracorporeal-co2-removal-as-bridge-to-lung-volume-reduction-surgery-in-end-stage-lung-emphysema
#13
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
https://www.readbyqxmd.com/read/27456703/the-feasibility-and-safety-of-extracorporeal-carbon-dioxide-removal-to-avoid-intubation-in-patients-with-copd-unresponsive-to-noninvasive-ventilation-for-acute-hypercapnic-respiratory-failure-eclair%C3%A2-study-multicentre-case-control-study
#14
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
https://www.readbyqxmd.com/read/27424471/extracorporeal-life-support-as-bridge-to-lung-retransplantation-a-multicenter-pooled-data-analysis
#15
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
https://www.readbyqxmd.com/read/27367886/update-in-critical-care-2015
#16
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
https://www.readbyqxmd.com/read/27290414/extracorporeal-co2-removal-in-hypercapnic-patients-who-fail-noninvasive-ventilation-and-refuse-endotracheal-intubation-a-case-series
#17
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
https://www.readbyqxmd.com/read/27290276/ultra-low-tidal-volumes-and-extracorporeal-carbon-dioxide-removal-hemolung-%C3%A2-ras-in-ards-patients-a-clinical-feasibility-study
#18
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
https://www.readbyqxmd.com/read/27290071/in-patients-under-extracorporeal-co2-removal-therapy-ecco2r-for-ards-can-we-do-prone-position-efficiency-stability-and-safety-of-the-maneuver
#19
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
https://www.readbyqxmd.com/read/27290060/an-innovative-technique-for-extracorporeal-carbon-dioxide-removal-featuring-an-electrodialysis-unit-an-in-vitro-experiment
#20
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
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