Journal article
Very low blood flow carbon dioxide removal system is not effective in a COPD exacerbation setting.
- Giraud R Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland.
- Banfi C Department of Cardio-thoracic Surgery, Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan, and Chair of Cardiac Surgery, University of Milan, Milan, Italy.
- Assouline B Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland.
- De Charrierre A Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland.
- Bendjelid K Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland.
- 2020-11-13
Published in:
- Artificial organs. - 2020
English
BACKGROUNDS
ECCO2 R is a low blood flow veno-venous ECMO technique that provides artificial blood CO2 removal. Recently, a new ECCO2 R system (Prismalung®), providing very low blood flow has been commercialized. The aim of this study is to report its use in severe COPD patients needing an ECCO2 R therapy.
METHODS
Six severe COPD patients with acute exacerbation leading to refractory hypercapnic respiratory acidosis were treated with ECCO2 R therapy. Two different systems were used: a Prismalung® system and a conventional ECCO2 R device.
RESULTS
The maximum blood flow provided by PrismaLung® was significantly lower than that with the conventional ECCO2 R system. In three patients initially treated with PrismaLung®, there were no improvements in pH, PaCO2 or RR. Thus, the therapy was switched to a conventional ECCO2 R system in these three patients, and three others were treated from the outset by the conventional ECCO2 R system, providing significant improvement in pH, PaCO2 and RR.
CONCLUSION
The present retrospective study describes the first use of PrismaLung® in severe COPD patients with acute exacerbation. When compared with a higher blood flow ECCO2 R system, our results show that this novel, very low-flow device is not able to remove sufficient CO2 , normalize pH or decrease respiratory rate.
ECCO2 R is a low blood flow veno-venous ECMO technique that provides artificial blood CO2 removal. Recently, a new ECCO2 R system (Prismalung®), providing very low blood flow has been commercialized. The aim of this study is to report its use in severe COPD patients needing an ECCO2 R therapy.
METHODS
Six severe COPD patients with acute exacerbation leading to refractory hypercapnic respiratory acidosis were treated with ECCO2 R therapy. Two different systems were used: a Prismalung® system and a conventional ECCO2 R device.
RESULTS
The maximum blood flow provided by PrismaLung® was significantly lower than that with the conventional ECCO2 R system. In three patients initially treated with PrismaLung®, there were no improvements in pH, PaCO2 or RR. Thus, the therapy was switched to a conventional ECCO2 R system in these three patients, and three others were treated from the outset by the conventional ECCO2 R system, providing significant improvement in pH, PaCO2 and RR.
CONCLUSION
The present retrospective study describes the first use of PrismaLung® in severe COPD patients with acute exacerbation. When compared with a higher blood flow ECCO2 R system, our results show that this novel, very low-flow device is not able to remove sufficient CO2 , normalize pH or decrease respiratory rate.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1111/aor.13867
- PMID 33184873
- Persistent URL
- https://folia.unifr.ch/global/documents/224662
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