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 journalConference article

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 languageEnglish (US)
Pages (from-to)1579-1580
Number of pages2
JournalAnnual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
Volume2
StatePublished - Dec 1 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

Keywords

  • ARDS
  • Arteriovenous CO removal
  • Mechanical ventilation

ASJC Scopus subject areas

  • Signal Processing
  • Biomedical Engineering
  • Computer Vision and Pattern Recognition
  • Health Informatics

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    Zwischenberger, J. B., Wang, D., Alpard, S. K., Savage, C., Deyo, D. J., Schmalstieg, F. C., & Bidani, A. (2002). Arterio venous carbon dioxide removal (AVCO2R) for severe respiratory failure. Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings, 2, 1579-1580.