Treatment of Acute Respiratory Failure with Low-Frequency Positive-Pressure Ventilation and Extracorporeal Removal of CO2

Gattinoni, Luciano; Presenti, A.; Rossi, Gianpaolo; Vesconi, S.; Fox, U.; Kolobow, Theodor; Agostoni, A; Pelizzola, A.; Langer, Monica; Uziel, Lilj; Longoni, F; Damia, G

doi:10.1097/00132586-198108000-00026

Cited by 33 publications

(43 citation statements)

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“…The goal of ECMO was shifted from "buying time for the lung to heal" to "rest the lung" and to protect it from further damage, a concept later known as ventilator-induced lung injury (VILI). In the same years, Gattinoni and Kolobow proposed to exploit ECMO to decrease respiratory rate, tidal volume, and airway pressure favoring lung healing (low frequency positive pressure ventilation, LFPPV; [7]). In 1994, however, the negative results of a second randomized clinical trial on the topic where published [21].…”

Section: Historical Backgroundmentioning

confidence: 99%

Ventilation during extracorporeal support

Pesenti

Carlesso

Länger

et al. 2017

Med Klin Intensivmed Notfmed

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Section: Historical Backgroundmentioning

confidence: 99%

Ventilation during extracorporeal support

Pesenti

Carlesso

Länger

et al. 2017

Med Klin Intensivmed Notfmed

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“…The premise of intervening with the ventilatory function of the lung stems from early work by Kolobow, Gattinoni and Pesenti, which showed that partial-to-total CO 2 removal and so 'ventilation' is possible by means of extracorporeal circulation of the blood through a gas exchange membrane [12,29,30]. Of all the available forms of extracorporeal gas exchange, partial lung support, also known as ECCO 2 R or respiratory dialysis, is the most promising, because it offers unique advantages while carrying a low potential for complications [31,32].…”

Section: New Extracorporeal Devices For Co 2 Removalmentioning

confidence: 99%

Update on the Role of Extracorporeal CO2 Removal as an Adjunct to Mechanical Ventilation in ARDS

Morimont¹,

Batchinsky²,

Lambermont³

2015

Annual Update in Intensive Care and Emergency Medicine

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“…The methodology pf extracorporeal CÖ 2 removai is described in detail elsewhere (22)(23)(24) Quantilies of pulmonary function and haemodynamics On each day of extracorporeal CO 2 removal treatment the pulmonary function was assessed by a sei of repräsentative Parameters. The intrapulmonal right-left shunt (Qs/Qr), alveolo-arterial oxygen pressure difference, mean pulmonary arterial pressure, and cardiac outpul were determined by Standard techniques.…”

Section: Extracorporeal Co 2 Removalmentioning

confidence: 99%

The Prognostic Value of Extracellular Matrix Component Concentrations in Serum During Treatment of Adult Respiratory Distress Syndrome with Extracorporeal CO2 Removal

Kropf¹,

Grobe²,

Knoch³

et al. 1991

Clinical Chemistry and Laboratory Medicine

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Summary:The time-dependent concentrations of hyaluronan, aminoterminal propeptide of type III procollagen, and laminin were determined in sera of 16 patients with severe adult respiratory distress syndrome during treatment with an extracorporeal CO 2 removal device. Patients were classified according to lung Parameters äs responders (n = 10) and non-responders (n = 6) to extracorporeal CO 2 removal. At the beginning of treatment strongly elevated serum concentrations of all studied extracellular matrix components were found. During the first 6-11 days of treatment the concentrations of aminoterminal propeptide of type III procollagen and hyaluronan increased further in non-responders but decreased in the majority of responders, while laminin decreased in both groups. No significant correlations were found between the serum concentrations of connective tissue components and the parameters of lung function. By non-parametric analysis of variance, significant differences between responders and non-responders according to treatment time could be established. By analysing the time course of the serum concentrations of hyaluronan and aminoterminal propeptide of type III procollagen, a total differentiation between responders and nonresponders was made pössible by the trends of these analytes äs early äs three days after the Start of treatment. The determination of aminoterminal propeptide of type III procollagen and hyaluronan in serum of patients with adult respiratory distress syndrome might therefore have prognostic significance in extracorporeal CO 2 removal. unfavourable rapid development of pulmonary fibroThe adult respiratory distress syndrome is a severe sis within about 2 weeks (5, 6), characterized by an condition of life-threatening organ failure, character-increase in fibroblast numbers and accelerated collaized by tachypnoea, hypoxaemia, diffuse interstitial gen metabolism (7,8). mfiltrates, alveolar oedema, and loss of lung compliance (l, 2). The syndrome develops in response to a Components of the extracellular matrix have been primary attack on lung cells like inhalation of toxins, determined in blood of patients with fibrotic lung aspiration of gastric contents (3) or äs a consequence diseases, but in contrast to e. g. liver fibrosis there of systemicdisorders like septicshock and multiorgan seems to be only a weak association between the trauma. Severe, progressive cases are associated with concentrations of such analytes in blood and the a mortality rate of up to 90% (4). One sequel of adult activity and/or grade of the fibrosing process in the respiratory distress syndrome is the prognostically lung (9).

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Treatment of Acute Respiratory Failure with Low-Frequency Positive-Pressure Ventilation and Extracorporeal Removal of CO2

Cited by 33 publications

References 0 publications

Ventilation during extracorporeal support

Ventilation during extracorporeal support

Update on the Role of Extracorporeal CO2 Removal as an Adjunct to Mechanical Ventilation in ARDS

The Prognostic Value of Extracellular Matrix Component Concentrations in Serum During Treatment of Adult Respiratory Distress Syndrome with Extracorporeal CO2 Removal

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