Document Detail


Hemodynamic stability during arteriovenous carbon dioxide removal for adult respiratory distress syndrome: a prospective randomized outcomes study in adult sheep.
MedLine Citation:
PMID:  11374759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the ability of arteriovenous carbon dioxide removal (AVCO2R) to maintain hemodynamic stability during treatment of adult respiratory distress syndrome (ARDS), we used our smoke/burn, LD40 sheep model of ARDS. With onset of ARDS (PaO2/FiO2 < 200) animals were randomized to AVCO2R (n = 20) or SHAM (n = 8). With AVCO2R, the carotid artery (10-14 F) and jugular vein (14-16 F) were cannulated; SHAM received identical management, sparing the vessels. AVCO2R maintained stable hemodynamics compared to SHAM at 48 hours; heart rate (114.8+/-6.1 vs. 110.1+/-11.0 beats/min.), mean arterial pressure (112+/-5.1 vs. 107.0+/-8.5 mm Hg), cardiac output (7.4+/-0.5 vs. 7.5+/-0.9 L/min.), pulmonary arterial pressure (26+/-2.4 vs. 21+/-1.3 mm Hg), pulmonary arterial wedge pressure (14.1+/-1.8 vs. 14.0+/-1.2 mm Hg), and central venous pressure (7+/-1.6 vs. 8+/-0.9 mm Hg). At 48 hours, AVCO2R allowed significant reductions (p<0.05) in minute ventilation (13.6+/-2.5 to 7.6+/-0.8 L/min); tidal volume (TV) (389.4+/-24.1 to 295.0+/-10.1 ml); peak inspiratory pressure (PIP) (25.4+/-9.2 to 18.8+/-2.5 cm H2O); RR (27.5+/-0.7 to 21.6+/-1.8 breaths/min); and FiO2 (0.96+/-0.00 to 0.48+/-0.2) while normocapnia was maintained. AVCO2R is an effective method of CO2 removal during severe respiratory failure that is hemodynamically well tolerated.
Authors:
J B Jayroe; S K Alpard; D Wang; D J Deyo; J A Murphy; J B Zwischenberger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  47     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    2001 May-Jun
Date Detail:
Created Date:  2001-05-25     Completed Date:  2001-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children, Galveston 77555-0528, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Animals
Blood Pressure
Burns / physiopathology
Carbon Dioxide / blood*
Cardiac Output
Central Venous Pressure
Disease Models, Animal
Extracorporeal Circulation*
Female
Heart Rate
Hemodynamics*
Prospective Studies
Pulmonary Wedge Pressure
Random Allocation
Respiration, Artificial
Respiratory Distress Syndrome, Adult / physiopathology*,  therapy*
Smoke Inhalation Injury / physiopathology,  therapy
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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