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  • Early experience of a new extracorporeal carbon dioxide removal device for acute hypercapnic respiratory failure

    Author(s)
    Tiruvoipati, Ravindranath
    Buscher, Hergen
    Winearls, James
    Breeding, Jeff
    Ghosh, Debasish
    Chaterjee, Shimonti
    Braun, Gary
    Paul, Eldho
    Fraser, John F
    Botha, John
    Griffith University Author(s)
    Fraser, John F.
    Year published
    2016
    Metadata
    Show full item record
    Abstract
    Background: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. Objective: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units. Methods: Retrospective review of all patients with acute or acute-on-chronic respiratory failure (due to ...
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    Background: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. Objective: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units. Methods: Retrospective review of all patients with acute or acute-on-chronic respiratory failure (due to chronic obstructive pulmonary disease [COPD] with severe hypercapnic respiratory failure when non-invasive ventilation failed; acute respiratory distress syndrome; COPD; or asthma when lung-protective ventilation was not feasible due to hypercapnia) for whom the Hemolung was used. Results: Fifteen patients were treated with ECCOR. In four out of five patients, the aim of avoiding intubation was achieved. In the remaining 10 patients, the strategy of instituting lung-protective ventilation was successful. The median duration for ECCOR was 5 days (interquartile range, 3-7 days). The pH and PCO2 improved significantly within 6 hours of instituting ECCOR, in conjunction with a significant reduction in minute ventilation. The CO2 clearance was 90–100 mL/min. A total of 93% of patients survived to weaning from ECCOR, 73% survived to ICU discharge and 67% survived to hospital discharge. Conclusion: Our data shows that ECCOR was safe and effective in this cohort. Further experience is vital to identify the patients who may benefit most from this promising therapy.
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    Journal Title
    Critical Care and Resuscitation
    Volume
    18
    Issue
    4
    Publisher URI
    https://search-informit-org.libraryproxy.griffith.edu.au/doi/10.3316/INFORMIT.515405062198667
    Subject
    Clinical sciences
    Nursing
    Science & Technology
    Life Sciences & Biomedicine
    Critical Care Medicine
    General & Internal Medicine
    POSITIVE-PRESSURE VENTILATION
    Publication URI
    http://hdl.handle.net/10072/408103
    Collection
    • Journal articles

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