Hemodynamic stability during arteriovenous carbon dioxide removal for adult respiratory distress syndrome: A prospective randomized outcomes study in adult sheep

Jason B. Jayroe, Scott K. Alpard, Dongfang Wang, Donald J. Deyo, Jennifer A. Murphy, Joseph B. Zwischenberger

    Research output: Contribution to journalArticle

    14 Citations (Scopus)

    Abstract

    To evaluate the ability of arteriovenous carbon dioxide removal (AVCO2R) to maintain hemodynamic stability during treatment of adult respiratory distress syndrome (ARDS), we used our smoke/burn, LD40 sheep model of ARDS. With onset of ARDS (PaO2/FiO2 < 200) animals were randomized to AVCO2R (n = 20) or SHAM (n = 8). With AVCO2R, the carotid artery (10-14 F) and jugular vein (14-16 F) were cannulated; SHAM received identical management, sparing the vessels. AVCO2R maintained stable hemodynamics compared to SHAM at 48 hours; heart rate (114.8 ± 6.1 vs. 110.1 ± 11.0 beats/min.), mean arterial pressure (112 ± 5.1 vs. 107.0 ± 8.5 mm Hg), cardiac output (7.4 ± 0.5 vs. 7.5 ± 0.9 L/min.), pulmonary arterial pressure (26 ± 2.4 vs. 21 ± 1.3 mm Hg), pulmonary arterial wedge pressure (14.1 ± 1.8 vs. 14.0 ± 1.2 mm Hg), and central venous pressure (7 ± 1.6 vs. 8 ± 0.9 mm Hg). At 48 hours, AVCO2R allowed significant reductions (p<0.05) in minute ventilation (13.6 ± 2.5 to 7.6 ± 0.8 L/min); tidal volume (TV) (389.4 ± 24.1 to 295.0 ± 10.1 mi); peak inspiratory pressure (PIP) (25.4 ± 9.2 to 18.8 ± 2.5 cm H2O); RR (27.5 ± 0.7 to 21.6 ± 1.8 breaths/min); and FiO2 (0.96 ± 0.00 to 0.48 ± 0.2) while normocapnia was maintained. AVCO2R is an effective method of CO2 removal during severe respiratory failure that is hemodynamically well tolerated.

    Original languageEnglish (US)
    Pages (from-to)211-214
    Number of pages4
    JournalASAIO Journal
    Volume47
    Issue number3
    StatePublished - 2001

    Fingerprint

    Adult Respiratory Distress Syndrome
    Hemodynamics
    Carbon Dioxide
    Sheep
    Carbon dioxide
    Arterial Pressure
    Outcome Assessment (Health Care)
    Central Venous Pressure
    Pulmonary Wedge Pressure
    Tidal Volume
    Jugular Veins
    Burns
    Carotid Arteries
    Smoke
    Respiratory Insufficiency
    Cardiac Output
    Ventilation
    Heart Rate
    Pressure
    Lung

    ASJC Scopus subject areas

    • Biophysics
    • Bioengineering

    Cite this

    Jayroe, J. B., Alpard, S. K., Wang, D., Deyo, D. J., Murphy, J. A., & Zwischenberger, J. B. (2001). Hemodynamic stability during arteriovenous carbon dioxide removal for adult respiratory distress syndrome: A prospective randomized outcomes study in adult sheep. ASAIO Journal, 47(3), 211-214.

    Hemodynamic stability during arteriovenous carbon dioxide removal for adult respiratory distress syndrome : A prospective randomized outcomes study in adult sheep. / Jayroe, Jason B.; Alpard, Scott K.; Wang, Dongfang; Deyo, Donald J.; Murphy, Jennifer A.; Zwischenberger, Joseph B.

    In: ASAIO Journal, Vol. 47, No. 3, 2001, p. 211-214.

    Research output: Contribution to journalArticle

    Jayroe, Jason B. ; Alpard, Scott K. ; Wang, Dongfang ; Deyo, Donald J. ; Murphy, Jennifer A. ; Zwischenberger, Joseph B. / Hemodynamic stability during arteriovenous carbon dioxide removal for adult respiratory distress syndrome : A prospective randomized outcomes study in adult sheep. In: ASAIO Journal. 2001 ; Vol. 47, No. 3. pp. 211-214.
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    abstract = "To evaluate the ability of arteriovenous carbon dioxide removal (AVCO2R) to maintain hemodynamic stability during treatment of adult respiratory distress syndrome (ARDS), we used our smoke/burn, LD40 sheep model of ARDS. With onset of ARDS (PaO2/FiO2 < 200) animals were randomized to AVCO2R (n = 20) or SHAM (n = 8). With AVCO2R, the carotid artery (10-14 F) and jugular vein (14-16 F) were cannulated; SHAM received identical management, sparing the vessels. AVCO2R maintained stable hemodynamics compared to SHAM at 48 hours; heart rate (114.8 ± 6.1 vs. 110.1 ± 11.0 beats/min.), mean arterial pressure (112 ± 5.1 vs. 107.0 ± 8.5 mm Hg), cardiac output (7.4 ± 0.5 vs. 7.5 ± 0.9 L/min.), pulmonary arterial pressure (26 ± 2.4 vs. 21 ± 1.3 mm Hg), pulmonary arterial wedge pressure (14.1 ± 1.8 vs. 14.0 ± 1.2 mm Hg), and central venous pressure (7 ± 1.6 vs. 8 ± 0.9 mm Hg). At 48 hours, AVCO2R allowed significant reductions (p<0.05) in minute ventilation (13.6 ± 2.5 to 7.6 ± 0.8 L/min); tidal volume (TV) (389.4 ± 24.1 to 295.0 ± 10.1 mi); peak inspiratory pressure (PIP) (25.4 ± 9.2 to 18.8 ± 2.5 cm H2O); RR (27.5 ± 0.7 to 21.6 ± 1.8 breaths/min); and FiO2 (0.96 ± 0.00 to 0.48 ± 0.2) while normocapnia was maintained. AVCO2R is an effective method of CO2 removal during severe respiratory failure that is hemodynamically well tolerated.",
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