Thomas Godet1, Alain Combes2, Elie Zogheib3, Matthieu Jabaudon4, Emmanuel Futier5, Arthur S Slutsky6, Jean-Michel Constantin7. 1. General Intensive Care Unit, réanimation adultes et unité de soins continus, département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France. Electronic address: tgodet@chu-clermontferrand.fr. 2. Medical-Surgical Intensive Care Unit, iCAN, Institute of Cardiometabolism and Nutrition, hôpital de la Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, Paris, France. Electronic address: alain.combes@psl.aphp.fr. 3. INSERM U-1088, Surgical Intensive Care Unit, Amiens University Hospital, Jules-Verne University of Picardy, Amiens, France. Electronic address: eliezogheib1@yahoo.fr. 4. General Intensive Care Unit, réanimation adultes et unité de soins continus, département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France; R2D2 - EA 7281, faculté de médecine, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France. Electronic address: mjabaudon@chu-clermontferrand.fr. 5. General Intensive Care Unit, réanimation adultes et unité de soins continus, département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France; R2D2 - EA 7281, faculté de médecine, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France. Electronic address: efutier@chu-clermontferrand.fr. 6. Department of Critical Care, Department of Medicine and Interdepartmental Division of Critical Care Medicine, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, St. Michael's Hospital, University of Toronto, 30, Bond Street, Toronto, Ontario M5B1W8, Canada. Electronic address: arthurslutsky@gmail.com. 7. General Intensive Care Unit, réanimation adultes et unité de soins continus, département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France; R2D2 - EA 7281, faculté de médecine, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France. Electronic address: jmconstantin@chu-clermontferrand.fr.
Abstract
OBJECTIVES: To study the technical effectiveness of a novel extracorporeal CO2 removal device in removing CO2 from blood. STUDY DESIGN: Prospective animal study. ANIMALS: Five adult female healthy pigs. METHODS: Hypercapnic pigs were equipped with a low-flow CO2 removal device (PrismaLung(®), Hospal(®)) integrated on a CRRT platform. The rate of CO2 elimination was examined in vivo using a hollow fiber gas exchanger under various conditions (blood flow rates: 200, 300 and 400 mL/min; sweep gas flows: 2, 5, 10 and 50 L/min; FsO2: 0.21 and 1). Statistical analysis was performed with Student t-test. RESULTS: The extracorporeal device produced CO2 removal rates ranging from 35 to 75 mL/min. Efficiency was increased with higher blood and sweep gas flows: reduction of PCO2 of 40.2 ± 13.0 mmHg (relative decrease of 46%, P < 0.001) and increase in pH of 0.24 ± 0.06 (7.21 before and 7.46 after filter, P < 0.001). Animals' blood gases were significantly modified after 10 minutes of treatment: PaCO2 decreased from 81.2 to 70.0 mmHg (relative decrease of 14%, P < 0.001) and pH increased from 7.17 to 7.22 (P < 0.001). No significant changes in arterial blood oxygenation were observed when using pure oxygen (increase of PaO2 from 106 to 107 mmHg, P = 0.36), allowing the use of ambient air as sweep gas through the membrane. CONCLUSIONS: A device based on a Prismaflex(®) platform was technically effective in removing CO2 from the blood, thus decreasing PaCO2 and acidosis in hypercapnic pigs.
OBJECTIVES: To study the technical effectiveness of a novel extracorporeal CO2 removal device in removing CO2 from blood. STUDY DESIGN: Prospective animal study. ANIMALS: Five adult female healthy pigs. METHODS: Hypercapnic pigs were equipped with a low-flow CO2 removal device (PrismaLung(®), Hospal(®)) integrated on a CRRT platform. The rate of CO2 elimination was examined in vivo using a hollow fiber gas exchanger under various conditions (blood flow rates: 200, 300 and 400 mL/min; sweep gas flows: 2, 5, 10 and 50 L/min; FsO2: 0.21 and 1). Statistical analysis was performed with Student t-test. RESULTS: The extracorporeal device produced CO2 removal rates ranging from 35 to 75 mL/min. Efficiency was increased with higher blood and sweep gas flows: reduction of PCO2 of 40.2 ± 13.0 mmHg (relative decrease of 46%, P < 0.001) and increase in pH of 0.24 ± 0.06 (7.21 before and 7.46 after filter, P < 0.001). Animals' blood gases were significantly modified after 10 minutes of treatment: PaCO2 decreased from 81.2 to 70.0 mmHg (relative decrease of 14%, P < 0.001) and pH increased from 7.17 to 7.22 (P < 0.001). No significant changes in arterial blood oxygenation were observed when using pure oxygen (increase of PaO2 from 106 to 107 mmHg, P = 0.36), allowing the use of ambient air as sweep gas through the membrane. CONCLUSIONS: A device based on a Prismaflex(®) platform was technically effective in removing CO2 from the blood, thus decreasing PaCO2 and acidosis in hypercapnicpigs.
Authors: Ingeborg Hospach; Jacques Goldstein; Kai Harenski; John G Laffey; Dominique Pouchoulin; Manuela Raible; Stefanie Votteler; Markus Storr Journal: Intensive Care Med Exp Date: 2020-05-13
Authors: Barbara Ficial; Francesco Vasques; Joe Zhang; Stephen Whebell; Michael Slattery; Tomas Lamas; Kathleen Daly; Nicola Agnew; Luigi Camporota Journal: Membranes (Basel) Date: 2021-03-22
Authors: Christian Karagiannidis; Stephan Strassmann; Daniel Brodie; Philine Ritter; Anders Larsson; Ralf Borchardt; Wolfram Windisch Journal: Intensive Care Med Exp Date: 2017-08-01