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  • Articles: DFG German National Licenses  (3)
  • 2005-2009
  • 1985-1989  (3)
  • ARDS  (2)
  • Extracorporeal gas exchange  (1)
  • 1
    ISSN: 1432-1238
    Keywords: ARDS ; Alveolar gas composition ; Low frequency positive pressure ventilation with extracorporeal CO2-removal ; Mass spectrometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tracheal and alveolar gas composition was studied by mass spectrometry in a patient with severe ARDS treated by low frequency positive pressure ventilation/extracorporeal CO2-removal (LFPPV-ECCO2R). Measured alveolar gas concentrations were compared with values derived from standard respiratory equations. As a result we found that during LFPPV-ECCO2R with a constant endotracheal O2-flow, alveolar gas composition cannot be predicted reliably from standard equations. The reasons for this finding are discussed. We conclude that monitoring of alveolar gas composition by mass spectrometry is of great value during LFPPV-ECCO2R if PAO2, P(A-a)O2 and Qva/Qt are to be determined correctly.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: ARDS ; Extracorporeal circulation ; Extracorporeal CO2-removal ; Extracorporeal membrane oxygenation ; Gas exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Extracorporeal circulation can cause lung damage, which would be especially counterproductive during extracorporeal gas exchange for the treatment of acute respiratory failure. To test the hypothesis that partial venovenous bypass with extracorporeal CO2-removal combined with low-frequency positive pressure ventilation (ECCO2R-LFPPV) can adversely affect lung fluid balance, extravascular thermal lung volume (ETV) and hemodynamics were assessed before, during and after ECCO2R-LFPPV in normal closed ehest dogs. In series I dogs (n=6) subjected to 10 h of ECCO2R-LFPPV, ETV did not change significantly from control (7.1 ml/kg±0.99 SE) during or after bypass. Gravimetric extravascular lung water and lung histology after bypass were found to be normal. In series II dogs (n=5), subjected to shorter periods of ECCO2R-LFPPV, ETV also remained unchanged. In contrast to previous reports using sheep, pulmonary arterial hypertension during bypass was not observed. Thus, ECCO2R-LFPPV was not associated with increased lung water, pulmonary hypertension or morphological lung changes under the conditions studied and does not seem to cause lung damage in normal lungs.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Acute respiratory failure ; Anticoagulation ; Artificial lung ; Extracorporeal gas exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Treatment of severe acute respiratory failure with extracorporeal gas exchange necessitating near complete systemic anticoagulation requires a delicate balance to be maintained between disseminated intravascular coagulation and hemorrhagic complications. The present study describes our first experience using a heparin coated extracorporeal artificial lung and circuitry during clinical extracorporeal CO2 removal. In spite of a partial thromboplastin time and activated clotting time within or close to the normal range, neither laboratory evidence for disseminated intravascular coagulation induced by the extracorporeal circuit nor thrombi in the pulmonary vasculature were found. Scanning electron microscopy of the heparin coated hollow fiber gas exchanger demonstrated only minor deposits on the surface. Use of a heparin coated artificial lung may enhance the margin of safety of extracorporeal gas exchange and ultimately broaden its indications.
    Type of Medium: Electronic Resource
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