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Extracorporeal co2 removal

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https://www.readbyqxmd.com/read/29434789/effects-of-pumpless-extracorporeal-lung-assist-on-hemodynamics-gas-exchange-and-inflammatory-cascade-response-during-experimental-lung-injury
#1
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 CO 2 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
#2
REVIEW
Tommaso Pettenuzzo, Eddy Fan, Lorenzo Del Sorbo
Extracorporeal carbon dioxide removal (ECCO 2 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 ECCO 2 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-difficult-as-for-ecmo-therapy
#3
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
No abstract text is available yet for this article.
February 5, 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
#4
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...
January 24, 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
#5
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
#6
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 (ECCO2R). 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. ECCO2R was performed using a ...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29211496/reply-to-precision-medicine-for-extracorporeal-co2-removal-for-ards-co2-physiological-considerations
#7
Ewan C Goligher, Marcelo B P Amato, Arthur S Slutsky
No abstract text is available yet for this article.
December 6, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29211495/precision-medicine-for-extracorporeal-co2-removal-for-ards-co2-physiological-considerations
#8
Luis Morales, Antonio Artigas, David A Kaufman
No abstract text is available yet for this article.
December 6, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29179681/low-flow-extracorporeal-co2-removal-in-ards-patients-a-prospective-short-term-crossover-pilot-study
#9
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 (ECCO2R). METHODS: This was a prospective pilot study, using the Abylcap® (Bellco) ECCO2R, with crossover off-on-off design (2-h blocks) under stable MV settings, and follow up till end of ECCO2R. Primary endpoint for effectiveness was a 20% reduction of PaCO2 after the first 2-h...
November 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29152939/right-patient-selection-and-management-in-veno-venous-extracorporeal-carbon-dioxide-removal
#10
Tommaso Pettenuzzo, Lorenzo Del Sorbo
No abstract text is available yet for this article.
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29140963/when-the-momentum-has-gone-what-will-be-the-role-of-extracorporeal-lung-support-in-the-future
#11
Darryl Abrams, Matthew Bacchetta, Daniel Brodie
PURPOSE OF REVIEW: There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain. RECENT FINDINGS: Outcomes for patients supported with extracorporeal devices continue to show favorable trends...
February 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#12
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
February 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29019893/rescue-therapeutic-strategy-combining-ultra-protective-mechanical-ventilation-with-extracorporeal-co2-removal-membrane-in-near-fatal-asthma-with-severe-pulmonary-barotraumas-a-case-report
#13
Arthur Pavot, Jihad Mallat, Nicolas Vangrunderbeeck, Didier Thevenin, Malcolm Lemyze
RATIONALE: Mechanical ventilation of severe acute asthma is still considered a challenging issue, mainly because of the gas trapping phenomenon with the potential for life-threatening barotraumatic pulmonary complications. PATIENT CONCERNS: Herein, we describe 2 consecutive cases of near-fatal asthma for whom the recommended protective mechanical ventilation approach using low tidal volume of 6 mL/kg and small levels of PEEP was rapidly compromised by giant pneumomediastinum with extensive subcutaneousemphysema...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28979565/protective-ventilation-with-veno-venous-lung-assist-in-respiratory-failure-a-protocol-for-a-multicentre-randomised-controlled-trial-of-extracorporeal-carbon-dioxide-removal-in-patients-with-acute-hypoxaemic-respiratory-failure
#14
J J McNamee, M A Gillies, N A Barrett, A M Agus, R Beale, A Bentley, A Bodenham, S J Brett, D Brodie, S J Finney, A J Gordon, M Griffiths, D Harrison, C Jackson, C McDowell, C McNally, G D Perkins, W Tunnicliffe, A Vuylsteke, T S Walsh, M P Wise, D Young, D F McAuley
One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure...
May 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/28979541/management-of-severe-traumatic-brain-injury-and-acute-respiratory-distress-syndrome-using-pumped-extracorporeal-carbon-dioxide-removal-device
#15
Tim Martindale, Phillip McGlone, Robert Chambers, Jon Fennell
The effects of a high carbon dioxide on cerebral perfusion and intracranial pressure are well known. We report the case of a man who presented after with a severe traumatic brain injury including intracranial and extradural haemorrhage. Neuroprotective ventilation was impossible without supramaximal tidal volumes due to a combination of chest trauma and severe bronchospasm. A pump driven Novalung iLA active® system was inserted to achieve both ARDSnet ventilation and a lowering of intracranial pressure. To our knowledge, this is the first time this system has been used to this effect...
February 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/28930639/50-years-of-research-in-ards-tidal-volume-selection-in-the-acute-respiratory-distress-syndrome
#16
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with the acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate tidal volume is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower tidal volumes, the use of tidal volumes of 6 mL/kg predicted body weight (PBW, based on sex and height) has been recommended in clinical practice guidelines...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28921478/interstitial-pneumonia-with-autoimmune-features-an-additional-risk-factor-for-ards
#17
Giacomo Grasselli, Beatrice Vergnano, Maria Rosa Pozzi, Vittoria Sala, Gabriele D'Andrea, Vittorio Scaravilli, Marco Mantero, Alberto Pesci, Antonio Pesenti
BACKGROUND: Interstitial pneumonia with autoimmune features (IPAF) identifies a recently recognized autoimmune syndrome characterized by interstitial lung disease and autoantibodies positivity, but absence of a specific connective tissue disease diagnosis or alternative etiology. We retrospectively reviewed the clinical presentation, diagnostic workup and management of seven critically ill patients who met diagnostic criteria for IPAF. We compared baseline characteristics and clinical outcome of IPAF patients with those of the population of ARDS patients admitted in the same period...
September 18, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28914339/do-we-need-randomized-clinical-trials-in-extracorporeal-respiratory-support-yes
#18
EDITORIAL
Alain Combes, Antonio Pesenti, Daniel Brodie
Extracorporeal respiratory support, also known as extracorporeal gas exchange, may be used to rescue the most severe forms of acute hypoxemic respiratory failure with high blood flow venovenous extracorporeal membrane oxygenation. Alternatively, lower flow extracorporeal carbon dioxide removal might be applied to reduce the intensity of mechanical ventilation in patients with less severe forms of the disease. However, critical reading of the results of the randomized trials and case series published to date reveals major methodological biases...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28875449/an-extracorporeal-carbon-dioxide-removal-ecco2r-device-operating-at-hemodialysis-blood-flow-rates
#19
R Garrett Jeffries, Laura Lund, Brian Frankowski, William J Federspiel
BACKGROUND: Extracorporeal carbon dioxide removal (ECCO2R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilation. We have developed an ultra-low-flow ECCO2R device (ULFED) capable of operating at blood flows comparable to renal hemodialysis (250 mL/min). Comparable operating conditions allow use of minimally invasive dialysis cannulation strategies with potential for direct integration to existing dialysis circuitry...
September 6, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#20
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
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