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Intravascular oxygenation for advanced respiratory failure
M J Jurmann1, S Demertzis, H J Schaefers
1Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|April 1, 1992
Summary
A novel intravascular oxygenator (IVOX) showed initial promise for severe respiratory failure, improving oxygenation in some patients. However, its limited gas transfer may restrict use in severe cases, though it shows potential for less severe respiratory conditions.
Area of Science:
- Medical Devices
- Respiratory Medicine
- Critical Care
Background:
- Severe acute respiratory failure necessitates artificial gas exchange support.
- Extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R) are established therapies.
- A totally implantable intravascular oxygenator (IVOX) is a newer device for gas exchange.
Observation:
- Three patients with severe respiratory failure (pneumonia or ARDS) were treated with IVOX.
- All patients presented with severe hypoxemia (PaO2 < 60 mmHg) despite maximal ventilation and oxygen.
- IVOX therapy duration varied from 12 to 71 hours.
Findings:
- Initial improvement in arterial oxygenation was observed in all patients.
- This allowed for a reduction in mechanical ventilator support.
- One patient experienced further deterioration and died from multi-organ failure; another died from unrelated causes; one patient survived long-term.
Implications:
- IVOX demonstrates potential utility in selected patients with less severe respiratory failure.
- Limited gas transfer capabilities of IVOX may restrict its application in severe acute respiratory distress syndrome.
- Further research is needed to define the optimal role of IVOX in respiratory support.