A randomized comparison of total extracorporeal CO2 removal with conventional mechanical ventilation in experimental hyaline membrane disease

Intensive Care Medicine
K L DorringtonA R Wilkinson

Abstract

Apnoeic oxygenation (AO) combined with extracorporeal CO2 removal (ECCO2R), using venovenous perfusion across a membrane area of 0.1 m2 has been shown to be feasible in six healthy anaesthetized rabbits. In a further twelve rabbits, ECCO2R has been randomly compared with conventional mechanical ventilation (CMV) following saline lavage to induce respiratory failure. Blood gases were maintained for up to 6 h within the same range (PaO2 = 8-20 kPa, PaCO2 = 4-6 kPa) in two groups of six by varying airway pressures and the oxygen fraction delivered either to the membrane lung (ECCO2R group) or to the ventilator (CMV group). The influence of single hourly sustained inflations (SI) on oxygenation was studied. ECCO2R subjects remained stable and survived. CMV subjects deteriorated and had 80% mortality. Hyaline membranes were absent from ECCO2R subjects and present in all CMV subjects. The response to SI suggests that a lung volume recruitment is maintained during AO for up to 1 h but is ineffective during CMV.

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Citations

Aug 1, 1996·Critical Care Medicine·D F WillsonH Dalton
Jan 1, 1990·Acta Anaesthesiologica Scandinavica. Supplementum·M K Sykes
Jan 1, 1991·Acta Anaesthesiologica Scandinavica. Supplementum·M K Sykes
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Jan 1, 1990·Intensive Care Medicine·K G Hickling
Jan 1, 1992·Intensive Care Medicine·D Dreyfuss, G Saumon
Sep 1, 1989·Journal of Biomedical Engineering·K M McRae, K L Dorrington
Oct 25, 2000·American Journal of Surgery·G MolsA Benzing

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