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https://www.readbyqxmd.com/read/28506729/-the-role-of-extracorporeal-removal-of-co2-ecco2r-in-the-management-of-respiratory-diseases
#1
J L Diehl, J Boisramé-Helms, A Chardon-Couteau, M Commereuc, J-L Augy, A Sokoloff, N Rivet, P Gaussem, D M Smadja, N Aissaoui
INTRODUCTION: The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows. STATE OF THE ART: For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28407675/-extracorporeal-co2-elimination-ecco2r-for-hypercapnic-respiratory-failure-from-pathophysiology-to-clinical-application
#2
C Karagiannidis, A Philipp, S Strassmann, S Schäfer, M Merten, W Windisch
Extracorporeal CO2 removal (ECCO2R) is becoming an increasingly established treatment option for patients with acute severe hypercapnic respiratory failure. Technically, pumpless arterio-venous systems using the natural arterio-venous pressure gradient and also pump-driven veno-venous systems are available. Here, veno-venous ECCO2R has become the preferred technique, as settings for arterio-venous ECCO2R are restricted and side effects are more common with arterio-venous ECCO2R. Using veno-venous ECCO2R with blood flow rates up to 450 ml/min 60 to 80 ml CO2 can be removed per minute corresponding to 20 to 30 % of the total amount of CO2 production...
April 2017: Pneumologie
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#3
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28275225/low-flow-veno-venous-extracorporeal-co2-removal-for-acute-hypercapnic-respiratory-failure
#4
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
BACKGROUND: Ventilation with low tidal volume and airway pressure results in a survival benefit in ARDS patients. Previous research suggests that avoiding mechanical ventilation altogether may be beneficial in some cases of respiratory failure. Our hypothesis was that low flow veno-venous extracorporeal CO2 removal (ECCO2R) enables maintenance of a lung protective ventilation strategy or awake spontaneous ventilation despite severe hypercapnic respiratory failure (HRF). METHODS: Twenty patients with HRF were investigated while mechanically ventilated (n=14) or breathing spontaneously close to respiratory exhaustion (n=6)...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28187047/is-extracorporeal-co2-removal-really-safe-and-less-invasive-observation-of-blood-injury-and-coagulation-impairment-during-ecco2r
#5
Johannes Kalbhenn, Nadine Neuffer, Barbara Zieger, Axel Schmutz
Extracorporeal CO2-Removal (ECCO2R) is promoted with attributes like "safe" and "less invasive" compared to (high-flow) veno-venous ECMO-Systems. With our experience in coagulation disorders during ECMO-therapy with this observational study we for the first time prospectively evaluate hemolysis and coagulation disorders during ECCO2R. Eight consecutive patients with predominant hypercapnic respiratory failure were treated with the Hemolung® Respiratory Assist System (RAS) (Alung-Technologies, Pittsburg, USA)...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28132075/extracorporeal-carbon-dioxide-removal-ecco2r-in-patients-with-acute-respiratory-failure
#6
REVIEW
Andrea Morelli, Lorenzo Del Sorbo, Antonio Pesenti, V Marco Ranieri, Eddy Fan
PURPOSE: To review the available knowledge related to the use of ECCO2R as adjuvant strategy to mechanical ventilation (MV) in various clinical settings of acute respiratory failure (ARF). METHODS: Expert opinion and review of the literature. RESULTS: ECCO2R may be a promising adjuvant therapeutic strategy for the management of patients with severe exacerbations of COPD and for the achievement of protective or ultra-protective ventilation in patients with ARDS without life-threatening hypoxemia...
April 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28114193/the-homburg-lung-efficacy-and-safety-of-a-minimal-invasive-pump-driven-device-for-veno-venous-extracorporeal-carbon-dioxide-removal
#7
Frederik Seiler, Franziska Trudzinski, Kai Hennemann, Tom Niermeyer, Christian Schmoll, Annegret Kamp, Robert Bals, Ralf Muellenbach, Hendrik Haake, Philipp M Lepper
Extracorporeal carbon dioxide removal (ECCO2R) is increasingly considered a viable therapeutic approach in the management of hypercapnic lung failure in order to avoid intubation or to allow lung-protective ventilator settings. This study aimed to analyze efficacy and safety of a minimal-invasive ECCO2R device, the Homburg lung. The Homburg lung is a pump-driven system for veno-venous ECCO2R with ¼" tubing and a 0.8 m surface oxygenator. Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#8
REVIEW
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/27836209/-extracorporeal-co2-removal-as-life-support-system-for-a-severe-organizing-pneumonia
#9
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...
December 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27562206/role-of-technology-for-the-management-of-aki-in-critically-ill-patients-from-adoptive-technology-to-precision-continuous-renal-replacement-therapy
#10
COMMENT
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
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...
August 1, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
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
#12
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
#13
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
#14
REVIEW
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...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27290253/ecco2r-a-french-national-survey
#15
B Deniau, J D Ricard, J Messika, D Dreyfuss, S Gaudry
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
#16
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/27290064/feasibility-of-the-implementation-of-a-technic-of-extra-corporeal-co2-removal-ecco2r-in-an-intensive-care-unit-which-doesn-t-use-ecmo-and-its-real-utilization
#17
V Amilien, J P Ponthus, P Ngasseu, E Barsam, P Lehericey, M Tchir, E Bezian, J F Georger
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27267600/adverse-effects-of-extracorporeal-carbon-dioxide-removal-ecco2r-for-acute-respiratory-failure-a-systematic-review-protocol
#18
REVIEW
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...
June 7, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27266291/removal-of-extracorporeal-carbon-dioxide-in-chronic-obstructive-pulmonary-disease-patients
#19
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
https://www.readbyqxmd.com/read/27195746/a-retrospective-observational-case-series-of-low-flow-venovenous-extracorporeal-carbon-dioxide-removal-use-in-patients-with-respiratory-failure
#20
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
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