Veno-venous extracorporeal CO2 removal for the treatment of severe respiratory acidosis
نویسندگان
چکیده
We read with interest the article by Karagiannidis and colleagues reporting the effects of extracorporeal CO2 removal (ECCO2R) in a pig model of severe respiratory acidosis [1]. However, their conclusion that blood flow rates between 750 and 1,000 ml/minute are necessary to correct severe acidosis using ECCO2R may have been biased by limitations in experimental methodology. Firstly, the authors report CO2 removal rates for various blood flow rates using 19Fr and 14Fr catheters. However, the data clearly demonstrated blood recirculation using the 14Fr catheter, reducing CO2 removal efficiency. Although the authors mention this limitation, it is curious why the 14Fr data were presented at all, since recirculation confounds meaningful interpretation. Secondly, a 15-minute equilibration time was used between experimental set points, but no evidence is provided that equilibrium was achieved. It is reasonable to
منابع مشابه
Veno-venous extracorporeal CO2 removal for the treatment of severe respiratory acidosis: pathophysiological and technical considerations
INTRODUCTION While non-invasive ventilation aimed at avoiding intubation has become the modality of choice to treat mild to moderate acute respiratory acidosis, many severely acidotic patients (pH <7.20) still need intubation. Extracorporeal veno-venous CO2 removal (ECCO2R) could prove to be an alternative. The present animal study tested in a systematic fashion technical requirements for succe...
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