Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure

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

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    1 Citation (Scopus)

    Abstract

    Arteriovenous carbon dioxide removal (AVCO 2R) by a low-resistance gas exchanger in a simple arteriovenous shunt is capable of achieving near total CO 2 removal and lung rest during ARDS. We evaluated AVCO 2R effect on a LD 50 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 AVCO 2R sheep survived, while only 2 SHAM animals survived the 7-day study. AVCO 2R 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 AVCO 2R at bedside and completed the 72-h trial and 3/5 patients were discharged. AVCO 2R removed approximately 70% of CO 2. 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 AVCO 2R was performed on 8 subjects with ARDS. PaCO 2 decreased significantly despite a decrease in minute ventilation from baseline and normalization of pH. We propose the normalization of CO 2 and decreased minute ventilation allows amelioration of the pathophysiology of ARDS.

    Original languageEnglish (US)
    Title of host publicationAnnual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
    Pages1579-1580
    Number of pages2
    Volume2
    StatePublished - 2002
    EventProceedings 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 2002Oct 26 2002

    Other

    OtherProceedings of the 2002 IEEE Engineering in Medicine and Biology 24th Annual Conference and the 2002 Fall Meeting of the Biomedical Engineering Society (BMES / EMBS)
    CountryUnited States
    CityHouston, TX
    Period10/23/0210/26/02

    Fingerprint

    Carbon Monoxide
    Carbon Dioxide
    Ventilation
    Carbon dioxide
    Smoke
    Animals
    Gases
    salicylhydroxamic acid

    Keywords

    • ARDS
    • Arteriovenous CO removal
    • Mechanical ventilation

    ASJC Scopus subject areas

    • Bioengineering

    Cite this

    Zwischenberger, J. B., Wang, D., Alpard, S. K., Savage, C., Deyo, D. J., Schmalstieg, F. C., & Bidani, A. (2002). Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure In Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings (Vol. 2, pp. 1579-1580)

    Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure . / Zwischenberger, Joseph B.; Wang, Dongfong; Alpard, Scott K.; Savage, Clare; Deyo, Donald J.; Schmalstieg, Frank C.; Bidani, Akhil.

    Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2 2002. p. 1579-1580.

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    Zwischenberger, JB, Wang, D, Alpard, SK, Savage, C, Deyo, DJ, Schmalstieg, FC & Bidani, A 2002, Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure in Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. vol. 2, pp. 1579-1580, 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, 10/23/02.
    Zwischenberger JB, Wang D, Alpard SK, Savage C, Deyo DJ, Schmalstieg FC et al. Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure In Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2. 2002. p. 1579-1580
    Zwischenberger, Joseph B. ; Wang, Dongfong ; Alpard, Scott K. ; Savage, Clare ; Deyo, Donald J. ; Schmalstieg, Frank C. ; Bidani, Akhil. / Arterio venous carbon dioxide removal (AVCO 2R) for severe respiratory failure Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2 2002. pp. 1579-1580
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