Arteriovenous Extracorporeal Carbon Dioxide Removal A Mathematical Model and Experimental Evaluation

Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study

“…In collaboration with Zwischenberger and Bidani, Conrad et al [13] developed a mathematical model to evaluate AVCO 2 R, validated it in a small animal model, and determined operating characteristics required for AV-CO 2 R to provide partial or total carbon dioxide removal. Brunston et al [35] determined that AVCO 2 R did not adversely affect cardiac output or organ blood flow at extracorporeal shunt fractions up to 29 %.…”

“…We have previously demonstrated in both mathematical and animal models that AVCO 2 R can remove clinically significant amounts of carbon dioxide [11,12,13] and permit significant reduction in ventilatory volumes and pressures [14,15,16]. Mathematical modeling has suggested that total carbon dioxide removal in humans is possible with the use of physiologically tolerable arteriovenous blood flow and the existing gas exchange capabilities of currently available membrane oxygenators [13]. AVCO 2 R is a simple extracorporeal technique that involves the insertion of a membrane gas exchange device in an arteriovenous shunt using percutaneous cannulation.…”

Removal of extracorporeal carbon dioxide in chronic obstructive pulmonary disease patients

“…The ECCO2R method demonstrated significant removal of CO 2 in both mathematical and animal models, as well as in a small-scale phase I clinical trials (7,8). These models and studies showed the removal of CO 2 and blood-flow rates at approximately 112 mL/min and > 500 mL/min, respectively (9).…”

Near-fatal pediatric asthma managed with pumpless arteriovenous carbon dioxide removal*

“…AVCO 2 R has demonstrated potential for significant carbon dioxide removal in a mathematical model (7), in animal studies (7,10), and in an adult human trial (8). Mathematical simulation has suggested that it is possible to achieve total CO 2 removal using an extracorporeal shunt fraction of only 10% to 15% of cardiac output and a sweep gas to blood flow ratio of Ն5 (7).…”

“…The flows required for extracorporeal CO 2 removal were determined experimentally by Conrad et al (7) using mathematical simulation and an experimental model. Based on these simulations, a blood flow on the order of 10% to 15% of the cardiac output was found to be capable of providing clinically relevant levels of CO 2 removal.…”