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Perfusion
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The contribution of arterio-venous extracorporeal lung assist to gas exchange in a porcine model of lavage-induced acute lung injury

Jörg Brederlau

Ralf Muellenbach

Markus Kredel

Ulrich Schwemmer

Martin Anetseder

Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany

Clemens Greim

Department of Anaesthesiology, Fulda Hospital, Fulda, Germany

Norbert Roewer

Department of Anaesthesiology, Würzburg University Hospital, Würzburg, Germany

This prospective large-animal study was performed to evaluate the contribution of arterio-venous extracorporeal lung assist (AV-ECLA) to pulmonary gas exchange in a porcine lavage-induced acute lung injury model. Fifteen healthy female pigs, weighing 50.39±3.8 kg (mean±SD), were included.

After induction of general anaesthesia and controlled ventilation, an arterial line and a pulmonary artery catheter were inserted. Saline lung lavage was performed until the PaO2 decreased to 51±16 mmHg. After a stabilization period of 60 min, the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed. Under apnoeic oxygenation, variations of sweep-gas flow were performed every 20 min in order to evaluate the membrane lung's efficacy, in terms of carbon dioxide (CO2) removal and oxygen (O2) uptake. Although AV-ECLA is highly effective in eliminating CO2, if combined with apnoeic oxygenation, normocapnia was not achievable. AV-ECLA's contribution to oxygenation during severe hypoxemia was antagonized by a significant increase in the pulmonary shunt fraction.

References

  • Morris AH, Wallace CJ, Menlove RL, Clemmet TP, Onme JF, Weaver LK, Dean VC, Thomas F, East TB, Pace NL. Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome . Am J Respir Crit Care Med 1994; 149: 295-305 .[Abstract]
  • Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagmiewski A, Miller RG. Extracorporeal membrane oxygenation in severe acute respiratory failure . A randomized prospective study. JAMA 1979; 242: 2193-2196 .
  • Rashkind W, Freeman A, Klein D, Toft R. Evaluation of a disposable plastic, low volume, pumpless oxygenator as a lung substitute . J Pediatr 1965; 66: 94-102 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Grubitzsch H, Beholz S, Wollert HG, Eckel L. Pumpless arteriovenous extracorporeal lung assist: what is its role? Perfusion 2000; 15: 237-242 .[Abstract/Free Full Text]
  • Tao W, Brunston RL Jr., Bidani A, Pirtle P, Dy J, Cardenas VJ, Fraser DL, Zwischenberger J. Significant reduction in minute ventilation and peak inspiratory pressures with arteriovenous CO2 removal during severe respiratory failure . Crit Care Med 1997; 25: 689-695 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Brunston RL Jr., Tao W, Bidani A, Alpard SK, Fraber DL, Zwischemberger JB. Prolonged hemodynamic stability during arteriovenous carbon dioxide removal for severe respiratory failure . J Thorac Cardiovasc Surg 1997; 114: 1107-1114 .[Abstract/Free Full Text]
  • Sussmane JB, Totapally BR, Hultquist K, Torbati D, Wolfsdorf J. Effects of arteriovenous extracorporeal therapy on hemodynamic stability, ventilation, and oxygenation in normal lambs . Crit Care Med 2001; 29: 1972-1978 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Reng M, Philipp A, Kaiser M, Pfeifer M, Gruene S, Schoelimerich J. Pumpless extracorporeal lung assist and adult respiratory distress syndrome . Lancet 2000; 356: 219-220 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Brederlau J, Anetseder M, Wagner R, Roesner T, Philipp A, Greim C, Roewer N. Pumpless extracorporeal lung assist in severe blunt chest trauma . J Cardiothorac Vasc Anesth 2004; 18: 777-779 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Gattinoni L, Kolobow T, Tomlinson T, Lapichino G, Samaja M, White D, Pierce J. Low-frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R): an experimental study . Anesth Analg 1978; 57: 470-477 .[Abstract/Free Full Text]
  • Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network . N Engl J Med 2000; 342: 1301-1308 .[Abstract/Free Full Text]
  • Lang JD, Figueroa M, Sanders KD, Aslam M, Liu Y, Chumley P, Freeman BA. Hypercapnia via reduced rate and tidal volume contributes to lipopolysaccharideinduced lung injury . Am J Respir Crit Care Med 2005; 171: 147-157 .[Abstract/Free Full Text]
  • Hickling KG, Walsh J, Henderson S, Jackson R. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study . Crit Care Med 1994; 22: 1568-1578 .[Web of Science][Medline] [Order article via Infotrieve]
  • Bein T, Scherer MN, Philipp A, Weber F, Woertgen C. Pumpless extracorporeal lung assist (pECLA) in patients with acute respiratory distress syndrome and severe brain injury . J Trauma 2005; 58: 1294-1297 .[Web of Science][Medline] [Order article via Infotrieve]
  • Domino KB, Wetstein L, Glasser SA, Lindgoem L, Marshall C, Harken A, Marshall BE. Influence of mixed venous oxygen tension (PVO2) on blood flow to atelectatic lung . Anesthesiology 1983; 59: 428-434 .[Web of Science][Medline] [Order article via Infotrieve]
  • Sandoval J, Long GR, Skoog C, Wood LD, Oppenheimer L. Independent influence of blood flow rate and mixed venous PO2 on shunt fraction . J Appl Physiol 1983; 55: 1128-1133 .[Abstract/Free Full Text]
  • Lachmann B. Open up the lung and keep the lung open . Intensive Care Med 1992; 18: 319-321 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kloot TE, Blanch L, Melgynne Youngblood A, Weinert C, Adams AB, Manini JJ, Slapino RS, Nalum A. Recruitment maneuvers in three experimental models of acute lung injury. Effect on lung volume and gas exchange . Am J Respir Crit Care Med 2000; 161: 1485-1494 .[Abstract/Free Full Text]
  • Imai Y, Parodo J, Kajikawa O, de Pennot M, Fischer S, Edward V, Cutz E, Liu M, Keshaujee S, Martin TR, Marshall JC, Rauieni VR, Slutsky AS. Injurious mechanical ventilation and end-organ epithelial cell apoptosis and organ dysfunction in an experimental model of acute respiratory distress syndrome . JAMA 2003; 289: 2104-2112 .[Abstract/Free Full Text]

Perfusion, Vol. 21, No. 5, 277-284 (2006)
DOI: 10.1177/0267659106074769
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T. Muller, M. Lubnow, A. Philipp, T. Bein, A. Jeron, A. Luchner, L. Rupprecht, M. Reng, J. Langgartner, C. E. Wrede, et al.
Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy
Eur. Respir. J., March 1, 2009; 33(3): 551 - 558.
[Abstract] [Full Text] [PDF]

This Article
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What's this?