Determination of low blood flow limits for arteriovenous carbon dioxide removal

Robert L. Brunston, Weike Tao, Akhil Bidani, Victor J. Cardenas, Daniel L. Traber, Joseph B. Zwischenberger

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Arteriovenous carbon dioxide removal (AVCO2R) has been shown to achieve total carbon dioxide (CO2) exchange. To determine optimal blood and gas flow parameters that can provide maximal gas exchange and evaluate the utility of AVCO2R at reduced blood flow, the authors used a low resistance membrane gas exchanger within an arteriovenous shunt in mechanically ventilated sheep. Adult female sheep (n = 5) were anesthetized and underwent placement of the gas exchange device in a simple arteriovenous shunt created between the carotid artery and common jugular vein. CO2 removal was determined as the product of the sweep gas flow (100% oxygen) and its exhaust CO2 content. Gas and blood flow were varied independently, and incremental reductions in minute ventilation (MV) were made while maintaining normocapnia. At maximally reduced ventilator settings, stepwise reductions in blood flow were made to determine the resultant changes in arterial PaCO2 at a sweep gas flow of 3 L/min. CO2 removal increased proportionally to blood flow to a maximum of 1,417 ± 26 ml/min (19% of cardiac output) and gas flow to 3 L/min. Normal PaO2 and PaCO2 could be maintained with minimal ventilator support (MV = 16% baseline MV) at a blood flow of 500 ml/min or higher. At these maximally reduced ventilator settings, moderate hypercapnia (PaCO2 ≤ 75 mmHg) resulted only when blood flow was decreased to below 500 ml/min. Optimizing AVCO2R blood and gas flow maximizes CO2 removal and allows a significant reduction in minute ventilation. In cases of severely limited blood flow, lung rest can still be realized at moderate hypercapnia. At flow rates achievable by percutaneous access, extracorporeal AVCO2R can be used to achieve lung rest during mechanical ventilation.

Original languageEnglish (US)
JournalASAIO Journal
Volume42
Issue number5
StatePublished - Sep 1996

Fingerprint

Carbon Dioxide
Carbon dioxide
Blood
Gases
Flow of gases
Ventilation
Mechanical Ventilators
Hypercapnia
Sheep
Lung
Common Carotid Artery
Jugular Veins
Artificial Respiration
Cardiac Output
Flow rate
Oxygen
Membranes
Equipment and Supplies

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

Brunston, R. L., Tao, W., Bidani, A., Cardenas, V. J., Traber, D. L., & Zwischenberger, J. B. (1996). Determination of low blood flow limits for arteriovenous carbon dioxide removal. ASAIO Journal, 42(5).

Determination of low blood flow limits for arteriovenous carbon dioxide removal. / Brunston, Robert L.; Tao, Weike; Bidani, Akhil; Cardenas, Victor J.; Traber, Daniel L.; Zwischenberger, Joseph B.

In: ASAIO Journal, Vol. 42, No. 5, 09.1996.

Research output: Contribution to journalArticle

Brunston, RL, Tao, W, Bidani, A, Cardenas, VJ, Traber, DL & Zwischenberger, JB 1996, 'Determination of low blood flow limits for arteriovenous carbon dioxide removal', ASAIO Journal, vol. 42, no. 5.
Brunston RL, Tao W, Bidani A, Cardenas VJ, Traber DL, Zwischenberger JB. Determination of low blood flow limits for arteriovenous carbon dioxide removal. ASAIO Journal. 1996 Sep;42(5).
Brunston, Robert L. ; Tao, Weike ; Bidani, Akhil ; Cardenas, Victor J. ; Traber, Daniel L. ; Zwischenberger, Joseph B. / Determination of low blood flow limits for arteriovenous carbon dioxide removal. In: ASAIO Journal. 1996 ; Vol. 42, No. 5.
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