Carbon dioxide dialysis will save the lung.

نویسندگان

  • Antonio Pesenti
  • Nicolò Patroniti
  • Roberto Fumagalli
چکیده

Mechanical ventilation and ventilator-associated lung injury could be avoided by decreasing the ventilatory needs of the patient by extracorporeal carbon dioxide removal. The reasons for the increased ventilatory needs of the patients with acute respiratory distress syndrome are outlined, as well as some of the mechanisms of continuing damage. Extracorporeal gas exchange has been used mainly as a rescue procedure for severely hypoxic patients. Although this indication remains valid, we propose that extracorporeal carbon dioxide removal could control the ventilatory needs of the patient and allow the maintenance of spontaneous breathing while avoiding intubation and decreasing the concurrent sedation needs. A scenario is depicted whereby an efficient carbon dioxide removal device can maintain blood gas homeostasis of the patient with invasiveness comparable to hemodialysis. High carbon dioxide removal efficiency may be achieved by combinations of hemofiltration and metabolizable acid loads.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future

Acute respiratory distress syndrome (ARDS) has a substantial mortality rate and annually affects more than 140,000 people in the USA alone. Standard management includes lung protective ventilation but this impairs carbon dioxide clearance and may lead to right heart dysfunction or increased intracranial pressure. Extracorporeal carbon dioxide removal has the potential to optimize lung protectiv...

متن کامل

Dialysis-Related Acidemia and Acidosis by Dialysate: The Forgotten Issue of CO2 Overload from Dialysate.

blood returning to the patient [2–4, 8] . This hypercapnia lowers pH despite high bicarbonate concentration but without hypoxia, unless lung disease coexists. The added CO 2 normally is quickly removed by respiration and systemic pCO 2 remains essentially unaffected. Having said that, ‘dialysis-related acidemia’ is the typical acid-base pattern of blood exiting the filter (venous line) in bicar...

متن کامل

Low-Flow Extracorporeal Carbon Dioxide Removal Using the Hemolung Respiratory Dialysis System® to Facilitate Lung-Protective Mechanical Ventilation in Acute Respiratory Distress Syndrome.

Extracorporeal carbon dioxide removal (ECCO2R) permits reductions in alveolar ventilation requirements that the lungs would otherwise have to provide. This concept was applied to a case of hypercapnia refractory to high-level invasive mechanical ventilator support. We present a case of an 18-year-old man who developed post-pneumonectomy acute respiratory distress syndrome (ARDS) after resection...

متن کامل

Influence of shielding gas composition on weld profile in pulsed Nd:YAG laser welding of low carbon steel

Weld area and weld depth/width ratio can be considered to be of the most important geometrical factors in pulsed laser welding. The effects of carbon dioxide and oxygen additions to the argon shielding gas on the weld properties in pulsed laser welding of low carbon steel is investigated. Presence of carbon dioxide and oxygen up to 10 and 15 percent respectively decreases the weld geometrical f...

متن کامل

Exergy and Energy Analysis of Effective Utilization of Carbon Dioxide in the Gas-to-Methanol Process

Two process models are used to convert carbon dioxide into methanol. These processes have been extended and improved using Aspen Plus simulator software. Both processes are found in the CO2 correction system. In this machine, the desired synthesis gas is produced in a flexible configuration. At the same time, the conversion of CO2 to hydrogen via a copper-based catalyst ha...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Critical care medicine

دوره 38 10 Suppl  شماره 

صفحات  -

تاریخ انتشار 2010