Abstract | OBJECTIVE: DESIGN: A phase I within-group time series trial in which subjects underwent up to 72 h of support with AVCO2R in intensive care units of two university hospitals. PATIENTS: INTERVENTIONS: Extracorporeal CO2 removal was achieved through percutaneous cannulation of the femoral artery and vein, and a simple extracorporeal circuit using a commercially available membrane gas exchange device for carbon dioxide exchange. MEASUREMENTS AND RESULTS: Measurements of hemodynamics, blood gases, ventilatory settings, and laboratory values were made before initiation of AVCO2R, and at subsequent intervals for 72 h. PaCO2 decreased significantly from 90.8+/-7.5 mmHg to 52.3+/-4.3 and 51.8+/-3.1 mmHg at 1 and 2 h, respectively. This decrease occurred despite a decrease in minute ventilation from a baseline of 6.92+/-1.64 l/min to 4.22+/-.46 and 3.00+/-.53 l/min at 1 and 2 h. There was a normalization of pH, with an increase from 7.19+/-.06 to 7.35+/-.07 and 7.37+/-.05 at 1 and 2 h. These improvements persisted during the full period of support with AVCO2R. Four subjects underwent apnea trials in which AVCO2R provided total carbon dioxide removal during apneic oxygenation, resulting in steady-state PaCO2 values from 57 to 85 mmHg. Hemodynamics were not significantly altered with the institution of AVCO2R. There were no major complications attributed to the procedure. CONCLUSION:
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Authors | S A Conrad, J B Zwischenberger, L R Grier, S K Alpard, A Bidani |
Journal | Intensive care medicine
(Intensive Care Med)
Vol. 27
Issue 8
Pg. 1340-51
(Aug 2001)
ISSN: 0342-4642 [Print] United States |
PMID | 11511947
(Publication Type: Clinical Trial, Clinical Trial, Phase I, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acute Disease
- Adult
- Aged
- Analysis of Variance
- Blood Gas Analysis
- Carbon Dioxide
(metabolism)
- Extracorporeal Circulation
(methods)
- Female
- Humans
- Hypercapnia
(etiology, therapy)
- Male
- Middle Aged
- Pilot Projects
- Regression Analysis
- Respiration, Artificial
- Respiratory Insufficiency
(complications, therapy)
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