Ultra-low tidal volumes and extracorporeal carbon dioxide removal (Hemolung RAS) in ARDS patients. A clinical feasibility study.

Ultra-low tidal volumes and extracorporeal carbon dioxide removal (Hemolung RAS) in ARDS patients. A clinical feasibility study

FJ Parrilla*, L Bergesio, H Aguirre-Bermeo, JC Suarez, P López, I Morán, J Mancebo
From ESICM LIVES 2015
Berlin, Germany. 3-7 October 2015

Summary:

  • Objective: To evaluate the effect of extracorporeal CO2 removal in ARDS during ultraprotective ventilation in terms of lung mechanics and gas exchange.
  • Methods: Ultraprotective ventilation was implemented in 9 ARDS patients by means of an extracorporeal CO2 removal system (Hemolung RAS). ABGs, respiratory and hemodynamic data were collected.
  • Results
    • Five men and four women with ARDS where studied (8 pneumonias and 1 abdominal sepsis)
    • Seven of these patients were treated with prone positioning during mechanical ventilation
    • Hemolung allowed a CO2 removal rate of 84 ± 9 mL/min with blood flow 447 ± 35 mL/min
    • No significant hemorrhage or hemolysis needing transfusion, device malfunction, insertion and/or withdrawal complications occurred.
    • A significant reduction in minute ventilation and alveolar minute ventilation (75% and 66%, respectively), dead space (68%), and driving pressure
      (69%), without significant changes in arterial blood gases when ultraprotective strategy was implemented, as compared to baseline
  • Conclusion: “Hemolung® system allows ultraprotective ventilation, while maintaining adequate arterial blood gases and significantly decreasing the intensity of ventilator assistance. The technique appears to be useful and safe.”

ultra-low tidal volumes and ECCO2R in ARDS ESICM 2015_Page_1

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