Extracorporeal perfusion for acute respiratory failure

Zapol, Warren M.; Qvist, J; Pontoppidan, Henning; Liland, Astrid; McEnany, Terry; Laver, Myron B.

doi:10.1016/s0022-5223(19)41569-9

Cited by 33 publications

(3 citation statements)

References 20 publications

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“…One is the development of a silicone rubber membrane oxygenator (TRUE Membrane) which offers molecular (gaseous) diffusion across the silicone membrane so that there is no actual blood-gas interface. This solid, nonporous barrier reportedly prevents gaseous microemboli and reduces platelet destruction and hemolysis (9,10,11).…”

Section: Di~u~ion-mentioning

confidence: 99%

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Zirbel,

Letson,

Kauffman

et al. 1990

J Extra Corpor Technol

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A major goal of new perfusion equipment is minimal trauma to blood elements. This study compares two perfusion systems, quantifies the change in blood components and generation of microemboli, as well as compares the hospital courses of each perfusion system. Forty-four coronary patients were assigned to either Group S, a silicone rubber membrane (SciMed) and centrifugal pump (Bio-Medicus) (N=19) or Group C (our routine equipment), a microporous polypropylene membrane (COBE CML) and roller pump (COBE)(N=25). The rise in plasma hemoglobin (26±14mg* in Group S and 26±17mg* in Group C), the drop in hematocrit (-15.0±3.9* in GroupS and -14.7±3.8* in Group Cat the second post-op day), and the decrease in platelet count (-152,000±78,000* in Group S and -129,000±52,000* in Group C) were similar in both groups. There was no difference in rise in post-op alveolararterial oxygen gradients or debris generated by each system. 27.7% in Group S required red cell transfusions and only 8% required red cell transfusions in Group C. There was no significant difference in clinical endpoints such as ICU stay, hospital stay and complication rate. We found no advantage to more expensive perfusion devices and no improvement upon the extensive CPB damage to formed blood elements.

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Section: Di~u~ion-mentioning

confidence: 99%

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Zirbel,

Letson,

Kauffman

et al. 1990

J Extra Corpor Technol

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“…/, Febnwry, 1986 reasons for using veno-arterial bypass during ECMO was to reduce pulmonary blood flow and thus possibly to reduce P A pressure and intrapulmonary shunt, but in fact a reduction of PA pressure was often not achieved. 44 Gattinoni's technique frequently achieves this without a reduction in pulmonary blood flow. The reduced P A pressure should result in a reduction in microvascular pressure, and this may be one of the mechanisms allowing resolution of the pulmonary oedema and improvement of radiographic appearance.…”

Section: Reduction Of Pulmonary Artery Pressurementioning

confidence: 99%

Extracorporeal CO₂ Removal in Severe Adult Respiratory Distress Syndrome

1986

Anaesth Intensive Care

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Sixty-five per cent survival has been achieved in a group of patients with severe ARDS and a predicted mortality of 92%, by the use of Gattinoni's technique of extracorporeal C02 removal. In patients and animals the technique has usually resulted in rapid improvement in the radiographic appearance and lung function. There are several possible mechanisms by which the technique may facilitate lung repair, including improvement of lung tissue oxygenation, the avoidance of high airway pressures and regional alkalosis in the lung, a reduction in oxygen toxicity, and the frequently observed reduction in pulmonary artery pressure. The apparent effectiveness of the technique and other associated evidence have implications which should lead us to reconsider some aspects of our conventional management of patients with severe ARDS.

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“…A few centers have systematically performed lung biopsies in early cases and have thus provided the best morphologic evidence concerning the first changes in ARDS. 2,3…”

Section: Definition and Clinical Course Of Ardsmentioning

confidence: 99%

Pathology of Adult Respiratory Distress Syndrome: Implications Regarding Therapy

Pratt¹

1982

Semin Respir Crit Care Med

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Extracorporeal perfusion for acute respiratory failure

Cited by 33 publications

References 20 publications

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Extracorporeal CO₂ Removal in Severe Adult Respiratory Distress Syndrome

Pathology of Adult Respiratory Distress Syndrome: Implications Regarding Therapy

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Extracorporeal perfusion for acute respiratory failure

Cited by 33 publications

References 20 publications

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Hematologic Derangements of Cardiopulmonary Bypass: A Comparison of Two Perfusion Systems

Extracorporeal CO2 Removal in Severe Adult Respiratory Distress Syndrome

Pathology of Adult Respiratory Distress Syndrome: Implications Regarding Therapy

Contact Info

Product

Resources

About

Extracorporeal CO₂ Removal in Severe Adult Respiratory Distress Syndrome