Respiratory electrodialysis a novel, highly efficient extracorporeal CO2 removal technique

American Journal of Respiratory and Critical Care Medicine

Volumn 192, Issue 6, 2015, Pages 719-726

  Zanella, Alberto ^a   Castagna, Luigi ^a   Salerno, Domenico ^a   Scaravilli, Vittorio ^a   El Sayed Deab, Salua Abd El Aziz ^a   Magni, Federico ^a   Giani, Marco ^a   Mazzola, Silvia ^b   Albertini, Mariangela ^b   Patroniti, Nicolò ^a,c   Mantegazza, Francesco ^a   Pesenti, Antonio ^a,c  

^a UNIVERSITY OF MILANO BICOCCA   (Italy)

^b UNIVERSITY OF MILAN   (Italy)

^c SAN GERARDO HOSPITAL   (Italy)

Author keywords

Carbon dioxide; Extracorporeal circulation; Hypercapnia; Respiratory insufficiency

Indexed keywords

BICARBONATE; CALCIUM ION; CARBON DIOXIDE; CHLORIDE ION; CREATININE; HEMOGLOBIN; LACTIC ACID; MAGNESIUM ION; POTASSIUM ION; PROTON; SODIUM ION; BIOLOGICAL MARKER;

ANIMAL EXPERIMENT; ARTERIAL CARBON DIOXIDE TENSION; ARTERIAL GAS; ARTICLE; ARTIFICIAL VENTILATION; BICARBONATE BLOOD LEVEL; BLOOD FILTER; BLOOD FLOW; BREATHING RATE; CALCIUM BLOOD LEVEL; CHLORIDE BLOOD LEVEL; CLINICAL EFFECTIVENESS; CREATININE BLOOD LEVEL; ELECTROLYTE BLOOD LEVEL; EXTRACORPOREAL CIRCULATION; GAS FLOW; HEMOFILTER; HEMOGLOBIN BLOOD LEVEL; HEMOLYSIS; IN VIVO STUDY; LACTATE BLOOD LEVEL; LUNG VENTILATION; MAGNESIUM BLOOD LEVEL; MEMBRANE; MEMBRANE LUNG; MINIMALLY INVASIVE PROCEDURE; NONHUMAN; OXYGEN SATURATION; PH; POTASSIUM BLOOD LEVEL; PRIORITY JOURNAL; RESPIRATORY ELECTRODIALYSIS; SODIUM BLOOD LEVEL; TIDAL VOLUME; VENTILATED PATIENT; ANIMAL; BLOOD; BLOOD GAS ANALYSIS; COMPLICATION; DIALYSIS; EVALUATION STUDY; HYPERCAPNIA; PIG; PROCEDURES; RESPIRATORY INSUFFICIENCY;

ANIMALS; BIOMARKERS; BLOOD GAS ANALYSIS; CARBON DIOXIDE; DIALYSIS; EXTRACORPOREAL CIRCULATION; HYPERCAPNIA; RESPIRATION, ARTIFICIAL; RESPIRATORY INSUFFICIENCY; SWINE; TIDAL VOLUME;

EID: 84942279139     PISSN: 1073449X     EISSN: 15354970     Source Type: Journal    
DOI: 10.1164/rccm.201502-0289OC     Document Type: Article

References (30)

1. Chastre J, Fagon J-Y. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002;165:867-903.
2. Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med 2013;369:2126-2136.
3. Powers SK, Kavazis AN, Levine S. Prolonged mechanical ventilation alters diaphragmatic structure and function. Crit Care Med 2009;37(10 Suppl):S347-S353.
4. Del Sorbo L, Pisani L, Filippini C, Fanelli V, Fasano L, Terragni P, Dell'Amore A, Urbino R, Mascia L, Evangelista A, et al. Extracorporeal Co2 removal in hypercapnic patients at risk of noninvasive ventilation failure: a matched cohort study with historical control. Crit Care Med 2015;43:120-127.
5. Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, Olsson KM, Greer M, Sommer W, Welte T, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med 2012;185:763-768.
6. Burki NK, Mani RK, Herth FJF, Schmidt W, Teschler H, Bonin F, Becker H, Randerath WJ, Stieglitz S, Hagmeyer L, et al. A novel extracorporeal CO(2) removal system: results of a pilot study of hypercapnic respiratory failure in patients with COPD. Chest 2013; 143:678-686.
7. Tramm R, Ilic D, Davies AR, Pellegrino VA, Romero L, Hodgson C. Extracorporeal membrane oxygenation for critically ill adults. Cochrane Database Syst Rev 2015;1:CD010381.
8. Ventetuolo CE, Muratore CS. Extracorporeal life support in critically ill adults. Am J Respir Crit Care Med 2014;190:497-508.
9. Bein T, Weber-Carstens S, Goldmann A, Müller T, Staudinger T, Brederlau J, Muellenbach R, Dembinski R, Graf BM, Wewalka M, et al. Lower tidal volume strategy (-3 ml/kg) combined with extracorporeal CO2 removal versus 'conventional' protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study. Intensive Care Med 2013;39:847-856.
10. Batchinsky AI, Jordan BS, Regn D, Necsoiu C, Federspiel WJ, Morris MJ, Cancio LC. Respiratory dialysis: reduction in dependence on mechanical ventilation by venovenous extracorporeal CO2 removal. Crit Care Med 2011;39:1382-1387.
11. Livigni S, Maio M, Ferretti E, Longobardo A, Potenza R, Rivalta L, Selvaggi P, Vergano M, Bertolini G. Efficacy and safety of a low-flow veno-venous carbon dioxide removal device: results of an experimental study in adult sheep. Crit Care 2006;10:R151.
12. Karagiannidis C, Kampe KA, Sipmann FS, Larsson A, Hedenstierna G, Windisch W, Mueller T. Veno-venous extracorporeal CO2 removal for the treatment of severe respiratory acidosis: pathophysiological and technical considerations. Crit Care 2014;18:R124.
13. Crotti S, Lissoni A, Tubiolo D, Azzari S, Tarsia P, Caspani L, Gattinoni L. Artificial lung as an alternative to mechanical ventilation in COPD exacerbation. Eur Respir J 2012;39:212-215.
14. Kluge S, Braune SA, Engel M, Nierhaus A, Frings D, Ebelt H, Uhrig A, Metschke M, Wegscheider K, Suttorp N, et al. Avoiding invasive mechanical ventilation by extracorporeal carbon dioxide removal in patients failing noninvasive ventilation. Intensive Care Med 2012;38: 1632-1639.
15. Hermann A, Staudinger T, Bojic A, Riss K, Wohlfarth P, Robak O, Sperr WR, Schellongowski P. First experience with a new miniaturized pump-driven venovenous extracorporeal CO2 removal system (iLA Activve): a retrospective data analysis. ASAIO J 2014;60: 342-347.
16. Pesenti A, Patroniti N, Fumagalli R. Carbon dioxide dialysis will save the lung. Crit Care Med 2010; 38(10, Suppl)S549-S554.
17. Cove ME, MacLaren G, Federspiel WJ, Kellum JA. Bench to bedside review: Extracorporeal carbon dioxide removal, past present and future. Crit Care 2012;16:232.
18. Abrams D, Roncon-Albuquerque R Jr, Brodie D. What's new in extracorporeal carbon dioxide removal for COPD? Intensive Care Med 2015;41:906-908.
19. Zanella A, Patroniti N, Isgrò S, Albertini M, Costanzi M, Pirrone F, Scaravilli V, Vergnano B, Pesenti A. Blood acidification enhances carbon dioxide removal of membrane lung: an experimental study. Intensive Care Med 2009;35:1484-1487.
20. Zanella A, Mangili P, Redaelli S, Scaravilli V, Giani M, Ferlicca D, Scaccabarozzi D, Pirrone F, Albertini M, Patroniti N, et al. Regional blood acidification enhances extracorporeal carbon dioxide removal: a 48-hour animal study. Anesthesiology 2014; 120:416-424.
21. Zanella A, Mangili P, Giani M, Redaelli S, Scaravilli V, Castagna L, Sosio S, Pirrone F, Albertini M, Patroniti N, et al. Extracorporeal carbon dioxide removal through ventilation of acidified dialysate: an experimental study. J Heart Lung Transplant 2014;33: 536-541.
22. Scaravilli V, Kreyer S, Linden K, Belenkiy S, Pesenti A, Zanella A, Cancio LC, Batchinsky AI. Enhanced extracorporeal CO2 removal by regional blood acidification: effect of infusion of three metabolizable acids. ASAIO J [online ahead of print] 4 May 2015; DOI: 10.1097/MAT.0000000000000238.
23. Brain M, Parkes S, Fowler P, Robertson I, Brown A. Calcium flux in continuous venovenous haemodiafiltration with heparin and citrate anticoagulation. Crit Care Resusc 2011;13:72-81.
24. Cressoni M, Zanella A, Epp M, Corti I, Patroniti N, Kolobow T, Pesenti A. Decreasing pulmonary ventilation through bicarbonate ultrafiltration: an experimental study. Crit Care Med 2009;37: 2612-2618.
25. Gille JP, Saunier C, Schrijen F, Hartemann D, Tousseul B. Metabolic CO2 removal by dialysis: THAM vs NaOH infusion. Int J Artif Organs 1989;12:720-727.
26. Nolte SH, Jonitz WJ, Grau J, Roth H, Assenbaum ER. Hemodialysis for extracorporeal bicarbonate/CO2 removal (ECBicCO2R) and apneic oxygenation for respiratory failure in the newborn. Theory and preliminary results in animal experiments. ASAIO Trans 1989;35:30-34.
27. Chang BS, Garella S. Complete extracorporeal removal of metabolic carbon dioxide by alkali administration and dialysis in apnea. Int J Artif Organs 1983;6:295-298.
28. Zanella A, Giani M, Redaelli S, Mangili P, Scaravilli V, Ormas V, Costanzi M, Albertini M, Bellani G, Patroniti N, et al. Infusion of 2.5 meq/min of Lactic Acid minimally increases CO2 production compared to an isocaloric glucose infusion in healthy anesthetized, mechanically ventilated pigs. Crit Care 2013;17:R268.
29. Terragni P, Maiolo G, Ranieri VM. Role and potentials of low-flow CO(2) removal system in mechanical ventilation. Curr Opin Crit Care 2012; 18:93-98.
30. Scaravilli V, Kreyer S, Linden K, Belenkiy S, Jordan B, Pesenti A, Zanella A, Chung K, Cannon J, Cancio LC, et al. Modular extracorporeal life support: effects of ultrafiltrate recirculation on the performance of an extracorporeal carbon dioxide removal device. ASAIO J 2014;60:335-341.