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Veno-venous extraco...
Veno-venous extracorporeal CO2 removal for the treatment of severe respiratory acidosis : pathophysiological and technical considerations
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Karagiannidis, Christian (författare)
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Kampe, Kristin Aufm (författare)
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- Sipmann, Fernando Suarez (författare)
- Uppsala universitet,Hedenstiernalaboratoriet
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- Larsson, Anders (författare)
- Uppsala universitet,Hedenstiernalaboratoriet
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- Hedenstierna, Göran (författare)
- Uppsala universitet,Hedenstiernalaboratoriet
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Windisch, Wolfram (författare)
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Mueller, Thomas (författare)
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(creator_code:org_t)
- Springer Science and Business Media LLC, 2014
- 2014
- Engelska.
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 18:3, s. R124-
- Relaterad länk:
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https://uu.diva-port... (primary) (Raw object)
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https://ccforum.biom...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- INTRODUCTION:While non-invasive ventilation aimed at avoiding intubation has become the modality of choice to treat mild to moderate acute respiratory acidosis, many severely acidotic patients (pH <7.20) still need intubation. Extracorporeal veno-venous CO2 removal (ECCO2R) could prove to be an alternative. The present animal study tested in a systematic fashion technical requirements for successful ECCO2R in terms of cannula size, blood and sweep gas flow.METHODS:ECCO2R with a 0.98 m2 surface oxygenator was performed in six acidotic (pH <7.20) pigs using either a 14.5 French (Fr) or a 19Fr catheter, with sweep gas flow rates of 8 and 16 L/minute, respectively. During each experiment the blood flow was incrementally increased to a maximum of 400 mL/minute (14.5Fr catheter) and 1000 mL/minute (19Fr catheter).RESULTS:Amelioration of severe respiratory acidosis was only feasible when blood flow rates of 750 to 1000 mL/minute (19Fr catheter) were used. Maximal CO2-elimination was 146.1 ± 22.6 mL/minute, while pH increased from 7.13 ± 0.08 to 7.41 ± 0.07 (blood flow of 1000 mL/minute; sweep gas flow 16 L/minute). Accordingly, a sweep gas flow of 8 L/minute resulted in a maximal CO2-elimination rate of 138.0 ± 16.9 mL/minute. The 14.5Fr catheter allowed a maximum CO2 elimination rate of 77.9 mL/minute, which did not result in the normalization of pH.CONCLUSIONS:Veno-venous ECCO2R may serve as a treatment option for severe respiratory acidosis. In this porcine model, ECCO2R was most effective when using blood flow rates ranging between 750 and 1000 mL/minute, while an increase in sweep gas flow from 8 to 16 L/minute had less impact on ECCO2R in this setting.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
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