Novel CO2 removal device driven by a renal-replacement system without hemofilter. A first step experimental validation - 16/06/15
, Alain Combes b , Elie Zogheib c , Matthieu Jabaudon a, d , Emmanuel Futier a, d , Arthur S. Slutsky e , Jean-Michel Constantin a, d, ⁎ Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objectives |
To study the technical effectiveness of a novel extracorporeal CO2 removal device in removing CO2 from blood.
Study design |
Prospective animal study.
Animals |
Five adult female healthy pigs.
Methods |
Hypercapnic pigs were equipped with a low-flow CO2 removal device (PrismaLung®, Hospal®) integrated on a CRRT platform. The rate of CO2 elimination was examined in vivo using a hollow fiber gas exchanger under various conditions (blood flow rates: 200, 300 and 400mL/min; sweep gas flows: 2, 5, 10 and 50 L/min; FsO2: 0.21 and 1). Statistical analysis was performed with Student t-test.
Results |
The extracorporeal device produced CO2 removal rates ranging from 35 to 75mL/min. Efficiency was increased with higher blood and sweep gas flows: reduction of PCO2 of 40.2±13.0mmHg (relative decrease of 46%, P<0.001) and increase in pH of 0.24±0.06 (7.21 before and 7.46 after filter, P<0.001). Animals’ blood gases were significantly modified after 10minutes of treatment: PaCO2 decreased from 81.2 to 70.0mmHg (relative decrease of 14%, P<0.001) and pH increased from 7.17 to 7.22 (P<0.001). No significant changes in arterial blood oxygenation were observed when using pure oxygen (increase of PaO2 from 106 to 107mmHg, P=0.36), allowing the use of ambient air as sweep gas through the membrane.
Conclusions |
A device based on a Prismaflex® platform was technically effective in removing CO2 from the blood, thus decreasing PaCO2 and acidosis in hypercapnic pigs.
Le texte complet de cet article est disponible en PDF.Keywords : Extracorporeal CO2 removal, Acute respiratory distress syndrome, Hypercapnia, Chronic obstructive pulmonary disease, Ventilator-induced lung injury
Abbreviations : ARDS, ART, BL, COPD, ECCO2R, ECLS, ECMO, FsO2, PECLA, PEEP, PRE, POST, RRT, SD, UFH, VILI
Plan
Vol 34 - N° 3
P. 135-140 - juin 2015 Retour au numéro
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