Pumpless extracorporeal removal of carbon dioxide combined with ventilation using low tidal volume and high positive end-expiratory pressure in a patient with severe acute respiratory distress syndrome.

Abstract

The effects of the combination of a 'lowest' lung ventilation with extracorporeal elimination of carbon dioxide by interventional lung assist are described in a patient presenting with severe acute respiratory distress syndrome due to fulminant pneumonia. Reducing tidal volume to 3 ml.kg(-1) together with interventional lung assist resulted in a decrease in severe hypercapnia without alveolar collapse or hypoxaemia but with a decrease in serum levels of interleukin-6. This approach was applied for 12 days with recovery of the patient, without complications. Extracorporeal removal of carbon dioxide by interventional lung assist may be a useful tool to enable 'ultraprotective' ventilation in severe acute respiratory distress syndrome.

• Authors: T Bein, M Zimmermann, K Hergeth, M Ramming, L Rupprecht, H J Schlitt, A S Slutsky
• Journal: Anaesthesia (Anaesthesia) Vol. 64 Issue 2 Pg. 195-8 (Feb 2009) ISSN: 1365-2044 [Electronic] England
• PMID: 19143699 (Publication Type: Case Reports, Journal Article)

Chemical References

• Carbon Dioxide
• Oxygen

Topics

• Carbon Dioxide (blood)
• Extracorporeal Membrane Oxygenation (methods)
• Humans
• Hypercapnia (blood, etiology, therapy)
• Male
• Middle Aged
• Oxygen (blood)
• Partial Pressure
• Respiration, Artificial (methods)
• Respiratory Distress Syndrome (blood, therapy)
• Tidal Volume