A novel extracorporeal CO2 removal system

• Verfasst von: Burki, Nausherwan K. [VerfasserIn]
• Verfasst von: Mani, Raj Kumar [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Schmidt, Werner [VerfasserIn]
• Verfasst von: Teschler, Helmut [VerfasserIn]
• Verfasst von: Bonin, Frank [VerfasserIn]
• Verfasst von: Becker, Heinrich [VerfasserIn]
• Verfasst von: Randerath, Winfried J. [VerfasserIn]
• Verfasst von: Stieglitz, Sven [VerfasserIn]
• Verfasst von: Hagmeyer, Lars [VerfasserIn]
• Verfasst von: Priegnitz, Christina [VerfasserIn]
• Verfasst von: Pfeifer, Michael [VerfasserIn]
• Verfasst von: Blaas, Stefan H. [VerfasserIn]
• Verfasst von: Putensen, Christian [VerfasserIn]
• Verfasst von: Theuerkauf, Nils [VerfasserIn]
• Verfasst von: Quintel, Michael [VerfasserIn]
• Verfasst von: Moerer, Onnen [VerfasserIn]
• Titel: A novel extracorporeal CO2 removal system
• Titelzusatz: results of a pilot study of hypercapnic respiratory failure in patients with COPD
• Verf.angabe: Nausherwan K. Burki, MD, PhD, FCCP; Raj Kumar Mani, MD, FCCP; Felix J.F. Herth, MD, FCCP; Werner Schmidt, MD; Helmut Teschler, MD; Frank Bonin, MD; Heinrich Becker, MD; Winfried J. Randerath, MD, FCCP; Sven Stieglitz, MD; Lars Hagmeyer, MD; Christina Priegnitz, MD; Michael Pfeifer, MD; Stefan H. Blaas, MD; Christian Putensen, MD, PhD; Nils Theuerkauf, MD; Michael Quintel, MD, PhD; and Onnen Moerer, MD
• Jahr: 2013
• Jahr des Originals: 2015
• Umfang: 9 S.
• Fussnoten: Available online: 16 December 2015 ; Im Titel ist "2" nach "CO" tiefer gestellt ; Gesehen am 09.12.2020
• Titel Quelle: Enthalten in: Chest
• Ort Quelle: Amsterdam : Elsevier, 1935
• Jahr Quelle: 2013
• Band/Heft Quelle: 143(2013), 3, Seite 678-686
• ISSN Quelle: 1931-3543
• DOI: doi:10.1378/chest.12-0228
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1742352952

Abstract

Background - Hypercapnic respiratory failure in patients with COPD frequently requires mechanical ventilatory support. Extracorporeal CO2 removal (ECCO2R) techniques have not been systematically evaluated in these patients. - Methods - This is a pilot study of a novel ECCO2R device that utilizes a single venous catheter with high CO2 removal rates at low blood flows. Twenty hypercapnic patients with COPD received ECCO2R. Group 1 (n = 7) consisted of patients receiving noninvasive ventilation with a high likelihood of requiring invasive ventilation, group 2 (n = 2) consisted of patients who could not be weaned from noninvasive ventilation, and group 3 (n = 11) consisted of patients on invasive ventilation who had failed attempts to wean. - Results - The device was well tolerated, with complications and rates similar to those seen with central venous catheterization. Blood flow through the system was 430.5 ± 73.7 mL/min, and ECCO2R was 82.5 ± 15.6 mL/min and did not change significantly with time. Invasive ventilation was avoided in all patients in group 1 and both patients in group 2 were weaned; PaCO2 decreased significantly (P < .003) with application of the device from 78.9 ± 16.8 mm Hg to 65.9 ± 11.5 mm Hg. In group 3, three patients were weaned, while the level of invasive ventilatory support was reduced in three patients. One patient in group 3 died due to a retroperitoneal bleed following catheterization. - Conclusions - This single-catheter, low-flow ECCO2R system provided clinically useful levels of CO2 removal in these patients with COPD. The system appears to be a potentially valuable additional modality for the treatment of hypercapnic respiratory failure. - Trial registry - ClinicalTrials.gov; No.: NCT00987740 and 01021605; URL: www.clinicaltrials.gov