Percutaneous venovenous CO2 removal with regional anticoagulation in an ovine model

Victor J. Cardenas, Lucinda Miller, James E. Lynch, Michael J. Anderson, Joseph B. Zwischenberger

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Extracorporeal CO2 removal may reduce minute ventilation requirements and allow for better tolerance of low tidal volume ventilating strategies in patients with severe respiratory insufficiency. Conventional extracorporeal gas exchange is labor-intensive, expensive, and usually requires systemic anticoagulation. In this study, a simplified venovenous circuit was developed by using regional citrate anticoagulation to avoid potential complications associated with systemic heparin. Five healthy adult sheep underwent percutaneous placement of a double-lumen 18F catheter into the internal jugular vein. The extracorporeal circuit consisted of a hollow fiber oxygenator and a variable speed roller pump. Regional anticoagulation consisted of a continuous citrate infusion to the inflow limb of the circuit. Systemic calcium levels were maintained by calcium chloride infusion through a central line. CO2 transfer was measured at varying levels of blood and gas flow. CO2 transfer ranged from 31 ml/min (500 ml/min blood flow; 2 l/min gas flow) to 150 ml/min (1000 ml/min blood flow; 15 l/min gas flow) and was directly proportional to blood flow and gas flow (p < 0.05). Normocapnia was maintained despite a 75% reduction in minute ventilation. At 24 hours, there was no significant clot formation in the circuit.

Original languageEnglish (US)
Pages (from-to)467-470
Number of pages4
JournalASAIO Journal
Volume52
Issue number4
DOIs
StatePublished - Jul 2006

Fingerprint

Flow of gases
Sheep
Blood
Gases
Networks (circuits)
Citric Acid
Ventilation
Oxygenators
Calcium Chloride
Calcium chloride
Catheters
Tidal Volume
Jugular Veins
Heparin
Calcium
Respiratory Insufficiency
Pumps
Personnel
Extremities
Fibers

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

Cardenas, V. J., Miller, L., Lynch, J. E., Anderson, M. J., & Zwischenberger, J. B. (2006). Percutaneous venovenous CO2 removal with regional anticoagulation in an ovine model. ASAIO Journal, 52(4), 467-470. https://doi.org/10.1097/01.mat.0000227743.07743.5d

Percutaneous venovenous CO2 removal with regional anticoagulation in an ovine model. / Cardenas, Victor J.; Miller, Lucinda; Lynch, James E.; Anderson, Michael J.; Zwischenberger, Joseph B.

In: ASAIO Journal, Vol. 52, No. 4, 07.2006, p. 467-470.

Research output: Contribution to journalArticle

Cardenas, VJ, Miller, L, Lynch, JE, Anderson, MJ & Zwischenberger, JB 2006, 'Percutaneous venovenous CO2 removal with regional anticoagulation in an ovine model', ASAIO Journal, vol. 52, no. 4, pp. 467-470. https://doi.org/10.1097/01.mat.0000227743.07743.5d
Cardenas, Victor J. ; Miller, Lucinda ; Lynch, James E. ; Anderson, Michael J. ; Zwischenberger, Joseph B. / Percutaneous venovenous CO2 removal with regional anticoagulation in an ovine model. In: ASAIO Journal. 2006 ; Vol. 52, No. 4. pp. 467-470.
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