Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future

Cove, Matthew E.; MacLaren, Graeme; Federspiel, William J.; Kellum, John A.

doi:10.1186/cc11356

Cited by 109 publications

(104 citation statements)

References 65 publications

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“…The use of extracorporeal carbon dioxide removal devices may be beneficial in this scenario. 40 Positioning the patient in a head-up position may help with both ventilation and reducing ICP.…”

Section: Pulmonarymentioning

confidence: 99%

Perioperative considerations of the patient with malaria

Soltanifar

Carvalho

Sultan

2014

Can J Anesth/J Can Anesth

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Purpose Malaria is a life-threatening infectious disease caused by the Plasmodium parasite. Increased global travel has resulted in an escalation in the number of imported cases seen in developed countries. Patients with malaria may present for surgery in both endemic and nonendemic countries. This article reviews the perioperative considerations when managing patients with malaria. Source A literature review of anesthesia, perioperative care, and malaria-related articles was performed using the MEDLINE Ò , EMBASE TM , and Web of Science databases to identify relevant articles published in English during . Of the 303 articles matching the search criteria, 265 were excluded based on title and abstract. Eleven of the remaining 38 articles were relevant to anesthesia/perioperative care, and 27 articles were identified as having direct relevance to critical care medicine. Principal findings The majority of imported malaria cases are caused by the falciparum species, which is associated with the greatest degree of morbidity and mortality. Various organ systems may be impacted as a consequence of changes in the structure and function of parasitized erythrocytes. Preoperative assessment should focus on establishing the species of malaria, the severity of disease, assessing the degree of end-organ impairment, and initiating treatment of malaria prior to surgery. Intravenous artesunate is the treatment of choice for severe falciparum malaria. Quinine is a second-line agent but has a narrow therapeutic index and particularly hazardous side effects. Intraoperatively, attention should focus on fluid management, dynamics of cerebral blood flow, and avoidance of hypoglycemia. Postoperative care of severe cases should ideally take place in a critical care unit as there may be ongoing requirements for multi-organ support, including renal replacement therapy, ventilation, and/or inotropic support. The safety of neuraxial anesthesia has not been well studied in the setting of malaria. Conclusions Malaria remains one of the most devastating infectious diseases worldwide. Multiple organ systems can be impacted as a consequence of changes in structure and function of parasitized erythrocytes. Safe perioperative management requires a sound knowledge of all these potential system effects. RésuméObjectif Le paludisme est une maladie infectieuse possiblement fatale due au parasite Plasmodium. La multiplication des voyages à travers le monde a entraîné un accroissement du nombre de cas importés observés dans les pays développés. Les patients atteints de paludisme peuvent nécessiter une chirurgie, aussi bien dans les pays où la maladie est endémique que dans les autres. Cet article passe en revue les considérations périopératoires lors de la prise en charge de patients atteints de paludisme. Source Une revue de la littérature à la recherche d'articles d'anesthésie, de soins périopératoires et en Author contributions Daniel Soltanifar, Brendan Carvalho, and Pervez Sultan all made substantial contributions to the literature review, ...

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Section: Pulmonarymentioning

confidence: 99%

Perioperative considerations of the patient with malaria

Soltanifar

Carvalho

Sultan

2014

Can J Anesth/J Can Anesth

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“…In conclusion, experience with ECMO has been 43 Karakurt et [36][37][38][39][40][41][42][43][44][45][46][47][48] improving with better survival rates and decreasing morbidity. Considering ECMO for patients with respiratory failure or heart failure when conventional therapies failed, if the underlying pathology is reversible or as a bridge to heart and/or lung transplantation is important.…”

Section: Prognosismentioning

confidence: 99%

“…If the patient has sufficient arterial pressure (arteriovenous pressure gradient ≥ 60 mm Hg), a pumpless system may be used in ECCOR. Otherwise, we have to use mechanical pump [42].…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

“…Venoarterial systems support heart and lung, venovenous systems support lung during ECMO. ECCOR (venovenous, lower blood flow rates system with or without pump) supports only lung 41 [36][37][38][39][40][41][42][43][44][45][46][47][48] ECCOR is provided to remove CO 2 and, unlike ECMO, does not provide significant oxygenation. In contrast to ECMO, where the need for oxygenation requires high blood flow rates, ECCOR allows much lower blood flow rates (500-1000mL/min) and needs smaller access cannulas.…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

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Improvements in intensive care units

Karakurt¹,

Yalçin²,

Arıkan³

2016

MMJ

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We have had some important improvements in the intensive care units (ICU) like high flow oxygen system (HFOS), therapeutic hypothermia, extra corporeal membrane oxygenation (ECMO), extra corporeal carbon dioxide removal (ECCOR), echocardiography (ECHO) and ultrasonography (US).HFOS gives oxygen to the patients at rates of flow higher (up to 60 L/min) than that delivered traditionally in LFOS (up to 16L/ min). It is obtained 1 cmH2O PEEP for every 10L/min of flow delivered by HFOS. HFOS serves as an important alternative to noninvasive mechanical ventilation especially in the management of the patients with hypoxemic respiratory failure.Post-resuscitation care consists of optimization of oxygenation and ventilation, avoiding hypotension, treating immediate precipitants of cardiac arrest such as acute coronary ischemia and initiating therapeutic (induced) hypothermia. Therapeutic hypothermia decreases cerebral metabolic rate, blood volume, and intracranial pressure, prevents reperfusion injury. So hypotermia protects cerebral functions.ECMO, the type of cardiopulmonary support, has become an essential tool in critical care patients with severe respiratory and cardiac failure, refractory to conventional therapy methods.Critical care ultrasonography (CCUS) and echocardiography have utility for intensivist-performed, immediate diagnoses of life threatening diseases, with no need to transport patients to radiology or cardiology departments or wait for radiologist or cardiologist on a consultative basis. CCUS and echocardiography should be an essential part of training of every ICU physician.

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“…Positive pressure ventilation improves oxygenation and CO2 removal by alveolar recruitment, increasing alveolar volume and redistribution of extracellular lung water. So it is reasonable to implement positive pressure ventilation in patients on high O2 like this level [6].…”

Section: Nimv Vs High-flow Oxygen Therapy (Hfot)mentioning

confidence: 99%

Noninvasive Mechanical Ventilation

Esquinas¹

2016

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Noninvasive mechanical ventilation (NIMV) has been widely applied to the patient with respiratory failure since 1990's around the world. The respiratory function of the patient with respiratory failure should be supported by using positive pressure ventilation until primary problem of the patient is treated. Positive pressure should be given noninvasively or invasively. If the patient is conscious (except unconsiousness due to CO2 retention) and has intact bulber function(sufficient cough reflex and swallowing function) and has stable clinical picture, we have to use NIMV instead of invasive mechanical ventilation (IMV). NIMV can be applied to the patient outside of the intensive care unit. The side effects of mechanical ventilation are significantly decreased during NIMV than that of IMV. Keywords: Noninvasive ventilation, Respiratory insufficiency IndicationsIncreased respiratory work that can be progressed to respiratory failure (respiratory rate>35/min, intercostal retractions, supraclavicular retractions, paradoxical breathing), respiratory failure and respiratory arrest are indications of mechanical ventilation in all diseases. Mechanical ventilatory support can be provided noninvasively if the patient is conscious (except unconsciousness due to CO2 retention) and has intact bulbar function (sufficient cough reflex and swallowing function) and has stable clinical picture. Mechanical ventilatory support is delivered to the patient through interfaces (nasal, oro-nasal, full face, helmet) during noninvasive mechanical ventilation (NIMV), but by using endotracheal tube or tracheotomy cannula during invasive mechanical ventilation (IMV). If NIMV is contraindicated, respiratory support should be given by using IMV. It is possible to avoid complications of intubation and IMV by using NIMV.Definition: NIMV is delivery of positive pressure ventilation to support respiratory function of the patient through interfaces. The respiratory function of the patient with respiratory failure should be supported by using mechanical ventilation, until primary problem of the patient is treated. There is no Indications of mechanical ventilation

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Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future

Cited by 109 publications

References 65 publications

Perioperative considerations of the patient with malaria

Perioperative considerations of the patient with malaria

Improvements in intensive care units

Noninvasive Mechanical Ventilation

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