Arterio venous carbon dioxide removal (AVCO2R) for severe respiratory failure

Joseph B. Zwischenberger; Dongfong Wang; Scott K. Alpard; Clare Savage; Donald J. Deyo; Frank C. Schmalstieg; Akhil Bidani

Arterio venous carbon dioxide removal (AVCO₂R) for severe respiratory failure

Joseph B. Zwischenberger, Dongfong Wang, Scott K. Alpard, Clare Savage, Donald J. Deyo, Frank C. Schmalstieg, Akhil Bidani

Research output: Contribution to journal › Conference article › peer-review

1 Scopus citations

Abstract

Arteriovenous carbon dioxide removal (AVCO₂R) by a low-resistance gas exchanger in a simple arteriovenous shunt is capable of achieving near total CO₂ removal and lung rest during ARDS. We evaluated AVCO₂R effect on a LD₅₀ smoke/burn (36 breath, 40% III° TBSA) ARDS model in a prospective, randomized, controlled, unblinded 7-day outcomes study of ventilator free days and survival. All AVCO₂R sheep survived, while only 2 SHAM animals survived the 7-day study. AVCO₂R had 2.4 ventilator dependent days versus 6.5 days with SHAM. Four our initial patient experience, 5 adults in unresponsive, severe ARDS were successfully cannulated for AVCO₂R at bedside and completed the 72-h trial and 3/5 patients were discharged. AVCO₂R removed approximately 70% of CO₂. Changes in ventilator parameters from baseline to 48 h included a decrease in tidal volume, peak inspiratory pressure, minute ventilation, and respiratory rate. Next, a before-after study of AVCO₂R was performed on 8 subjects with ARDS. PaCO₂ decreased significantly despite a decrease in minute ventilation from baseline and normalization of pH. We propose the normalization of CO₂ and decreased minute ventilation allows amelioration of the pathophysiology of ARDS.

Original language	English (US)
Pages (from-to)	1579-1580
Number of pages	2
Journal	Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
Volume	2
State	Published - 2002
Externally published	Yes
Event	Proceedings of the 2002 IEEE Engineering in Medicine and Biology 24th Annual Conference and the 2002 Fall Meeting of the Biomedical Engineering Society (BMES / EMBS) - Houston, TX, United States Duration: Oct 23 2002 → Oct 26 2002

Keywords

ARDS
Arteriovenous CO removal
Mechanical ventilation

ASJC Scopus subject areas

Signal Processing
Biomedical Engineering
Computer Vision and Pattern Recognition
Health Informatics

Cite this

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title = "Arterio venous carbon dioxide removal (AVCO2R) for severe respiratory failure",

abstract = "Arteriovenous carbon dioxide removal (AVCO2R) by a low-resistance gas exchanger in a simple arteriovenous shunt is capable of achieving near total CO2 removal and lung rest during ARDS. We evaluated AVCO2R effect on a LD50 smoke/burn (36 breath, 40% III° TBSA) ARDS model in a prospective, randomized, controlled, unblinded 7-day outcomes study of ventilator free days and survival. All AVCO2R sheep survived, while only 2 SHAM animals survived the 7-day study. AVCO2R had 2.4 ventilator dependent days versus 6.5 days with SHAM. Four our initial patient experience, 5 adults in unresponsive, severe ARDS were successfully cannulated for AVCO2R at bedside and completed the 72-h trial and 3/5 patients were discharged. AVCO2R removed approximately 70% of CO2. Changes in ventilator parameters from baseline to 48 h included a decrease in tidal volume, peak inspiratory pressure, minute ventilation, and respiratory rate. Next, a before-after study of AVCO2R was performed on 8 subjects with ARDS. PaCO2 decreased significantly despite a decrease in minute ventilation from baseline and normalization of pH. We propose the normalization of CO2 and decreased minute ventilation allows amelioration of the pathophysiology of ARDS.",

keywords = "ARDS, Arteriovenous CO removal, Mechanical ventilation",

author = "Zwischenberger, {Joseph B.} and Dongfong Wang and Alpard, {Scott K.} and Clare Savage and Deyo, {Donald J.} and Schmalstieg, {Frank C.} and Akhil Bidani",

year = "2002",

language = "English (US)",

volume = "2",

pages = "1579--1580",

journal = "Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings",

issn = "0589-1019",

publisher = "Institute of Electrical and Electronics Engineers Inc.",

note = "Proceedings of the 2002 IEEE Engineering in Medicine and Biology 24th Annual Conference and the 2002 Fall Meeting of the Biomedical Engineering Society (BMES / EMBS) ; Conference date: 23-10-2002 Through 26-10-2002",

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TY - JOUR

T1 - Arterio venous carbon dioxide removal (AVCO2R) for severe respiratory failure

AU - Zwischenberger, Joseph B.

AU - Wang, Dongfong

AU - Alpard, Scott K.

AU - Savage, Clare

AU - Deyo, Donald J.

AU - Schmalstieg, Frank C.

AU - Bidani, Akhil

PY - 2002

Y1 - 2002

N2 - Arteriovenous carbon dioxide removal (AVCO2R) by a low-resistance gas exchanger in a simple arteriovenous shunt is capable of achieving near total CO2 removal and lung rest during ARDS. We evaluated AVCO2R effect on a LD50 smoke/burn (36 breath, 40% III° TBSA) ARDS model in a prospective, randomized, controlled, unblinded 7-day outcomes study of ventilator free days and survival. All AVCO2R sheep survived, while only 2 SHAM animals survived the 7-day study. AVCO2R had 2.4 ventilator dependent days versus 6.5 days with SHAM. Four our initial patient experience, 5 adults in unresponsive, severe ARDS were successfully cannulated for AVCO2R at bedside and completed the 72-h trial and 3/5 patients were discharged. AVCO2R removed approximately 70% of CO2. Changes in ventilator parameters from baseline to 48 h included a decrease in tidal volume, peak inspiratory pressure, minute ventilation, and respiratory rate. Next, a before-after study of AVCO2R was performed on 8 subjects with ARDS. PaCO2 decreased significantly despite a decrease in minute ventilation from baseline and normalization of pH. We propose the normalization of CO2 and decreased minute ventilation allows amelioration of the pathophysiology of ARDS.

AB - Arteriovenous carbon dioxide removal (AVCO2R) by a low-resistance gas exchanger in a simple arteriovenous shunt is capable of achieving near total CO2 removal and lung rest during ARDS. We evaluated AVCO2R effect on a LD50 smoke/burn (36 breath, 40% III° TBSA) ARDS model in a prospective, randomized, controlled, unblinded 7-day outcomes study of ventilator free days and survival. All AVCO2R sheep survived, while only 2 SHAM animals survived the 7-day study. AVCO2R had 2.4 ventilator dependent days versus 6.5 days with SHAM. Four our initial patient experience, 5 adults in unresponsive, severe ARDS were successfully cannulated for AVCO2R at bedside and completed the 72-h trial and 3/5 patients were discharged. AVCO2R removed approximately 70% of CO2. Changes in ventilator parameters from baseline to 48 h included a decrease in tidal volume, peak inspiratory pressure, minute ventilation, and respiratory rate. Next, a before-after study of AVCO2R was performed on 8 subjects with ARDS. PaCO2 decreased significantly despite a decrease in minute ventilation from baseline and normalization of pH. We propose the normalization of CO2 and decreased minute ventilation allows amelioration of the pathophysiology of ARDS.

KW - ARDS

KW - Arteriovenous CO removal

KW - Mechanical ventilation

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Y2 - 23 October 2002 through 26 October 2002

ER -

Arterio venous carbon dioxide removal (AVCO₂R) for severe respiratory failure

Abstract

Keywords

ASJC Scopus subject areas

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