Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist

Zimmermann, Markus; Bein, Thomas; Philipp, Alois; Ittner, Karl Peter; Foltan, Maik; Drescher, J.; Weber, Frank; Schmid, Franz X.

doi:10.1093/bja/aei274

Cited by 67 publications

(41 citation statements)

References 8 publications

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“…Most studies in humans have described a significant rise in Pa,O 2 after implementation of iLA treatment [6][7][8][16][17][18]. The patients evaluated in the current study had a Pa,O 2 /FI,O 2 ratio of 69 mmHg before iLA treatment, which increased to 94 mmHg within 2 h (p,0.001).…”

Section: Effects On Oxygen Transportmentioning

confidence: 51%

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Müller¹,

Lubnow²,

Philipp³

et al. 2008

Eur Respir J

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Respiratory acidosis can become a serious problem during protective ventilation of severe lung failure. A pumpless arteriovenous interventional lung assist (iLA) for extracorporeal carbon dioxide removal has been used increasingly to control critical respiratory situations. The present study sought to evaluate the factors determining the efficacy of iLA and calculate its contribution to gas exchange.In a cohort of 96 patients with severe acute respiratory distress syndrome, haemodynamic parameters, oxygen consumption and carbon dioxide production as well as gas transfer through the iLA were analysed.The measurements demonstrated a significant dependency of blood flowviathe iLA device on cannula size (mean±sd1.59±0.52 L·min−1for 15 French (Fr), 1.94±0.35 L·min−1for 17 Fr, and 2.22 ±0.45 L·min−1for 19 Fr) and on mean arterial pressure. Oxygen transfer capacity averaged 41.7±20.8 mL·min−1, carbon dioxide removal was 148.0±63.4 mL·min−1. Within two hours of iLA treatment, arterial oxygen partial pressure/inspired oxygen fraction ratio increased significantly and a fast improvement in arterial carbon dioxide partial pressure and pH was observed.Interventional lung assist eliminates ∼50% of calculated total carbon dioxide production with rapid normalisation of respiratory acidosis. Despite limited contribution to oxygen transfer it may allow a more protective ventilation in severe respiratory failure.

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Section: Effects On Oxygen Transportmentioning

confidence: 51%

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Müller¹,

Lubnow²,

Philipp³

et al. 2008

Eur Respir J

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“…Outro ponto a ser abordado é o fato de que, segundo ZIMMERMANN et al (2006) e KOOP et al (2006, a transferência de oxigênio no desvio artério-venoso pode não ser sufi ciente justamente porque o sangue que chega ao oxigenador é o arterial, sendo este desvio cardiopulmonar capaz de promover apenas um aumento moderado da oxigenação. Porém, como os animais do grupo 2 não receberam ventilação mecânica e apresentavam-se em apneia, o sangue que alcançava o oxigenador possuía características venosas e, teoricamente, deveria ser capaz de alcançar um nível de saturação alto, como se pôde comprovar com os dados apresentados pelo animal 6, cuja SatO 2 foi excelente.…”

Section: Resultsunclassified

Oxigenação extracorpórea por membrana em cães sem auxílio circulatório

et al. 2014

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“…32,33 However, these are all case reports or very small case series and as such do not provide any definitive evidence of benefit.…”

Section: Current Evidencementioning

confidence: 99%

Extracorporeal Carbon Dioxide Removal (ECCO₂R) in Respiratory Failure: An Overview, and where Next?

Baker

Richardson

Craig

2012

Journal of the Intensive Care Society

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Extracorporeal carbon dioxide removal (ECCO2R) is used to facilitate protective ventilation strategies and to treat severe hypercapnic acidosis that is refractory to mechanical ventilation. There is an increasing amount of interest in the use of ECCO2R but there are no recommendations for its use that take the most recent evidence into account. In 2008, the National Institute of Health and Clinical Excellence (NICE) published guidelines on ‘Arteriovenous Extracorporeal Membrane Carbon Dioxide Removal.’1 However, since that time there have been a number of studies in the area and some significant technological advances including the introduction of commercially available VV-ECCO2R systems. The aim of this article is to provide an overview of ECCO2R, review the literature relating to its use and discuss its future role in the intensive care setting.

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Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist

Abstract: Due to ease of handling, high effectiveness and relatively low costs, iLA seems to be a useful system for treatment and transportation of patients with severe acute lung injury or ARDS suffering from life-threatening hypoxia and/or hypercapnia.

Cited by 67 publications

References 8 publications

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Oxigenação extracorpórea por membrana em cães sem auxílio circulatório

Extracorporeal Carbon Dioxide Removal (ECCO₂R) in Respiratory Failure: An Overview, and where Next?

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Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist

Abstract: Due to ease of handling, high effectiveness and relatively low costs, iLA seems to be a useful system for treatment and transportation of patients with severe acute lung injury or ARDS suffering from life-threatening hypoxia and/or hypercapnia.

Cited by 67 publications

References 8 publications

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy

Oxigenação extracorpórea por membrana em cães sem auxílio circulatório

Extracorporeal Carbon Dioxide Removal (ECCO2R) in Respiratory Failure: An Overview, and where Next?

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Product

Resources

About

Extracorporeal Carbon Dioxide Removal (ECCO₂R) in Respiratory Failure: An Overview, and where Next?