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Prolonged pumpless arteriovenous perfusion for carbon dioxide extraction
J A Awad1, J Deslauriers, D Major
1Department of Surgery, Faculty of Medicine, Laval University, Ste-Foy, Québec, Canada.
The Annals of Thoracic Surgery
|April 1, 1991
Summary
This study shows that microporous membrane oxygenators can efficiently remove carbon dioxide from blood during pumpless extracorporeal circuits, offering potential for partial respiratory support with minimal adverse effects like hemolysis.
Area of Science:
- Cardiovascular Physiology
- Respiratory Support Technologies
- Biomedical Engineering
Background:
- Partial respiratory support is crucial for patients with respiratory failure.
- Extracorporeal carbon dioxide removal (ECCO2R) offers a less invasive alternative to full mechanical ventilation.
- Pumpless extracorporeal systems aim to reduce invasiveness and complexity.
Purpose of the Study:
- To evaluate the efficacy and safety of a microporous membrane oxygenator for extracorporeal carbon dioxide extraction.
- To assess the feasibility of using this system for partial respiratory support during pumpless arteriovenous perfusions.
- To investigate the physiological effects and biocompatibility of the system in animal models.
Main Methods:
- Evaluation of a microporous membrane oxygenator for extracorporeal carbon dioxide extraction.
- Pumpless arteriovenous perfusion in canine and ovine models.
- Assessment of hemodynamic parameters, blood gas exchange, hemolysis, and hematological markers.
- Continuous bypass monitoring over 3 to 7 days.
Main Results:
- Canine studies showed an increase in cardiac output and work, though less than expected.
- Ovine studies demonstrated minimal hemolysis and stable hemoglobin/hematocrit levels over 7 days.
- Platelet counts remained within safe limits; extracorporeal blood flow slightly decreased over time.
- Efficient carbon dioxide extraction was maintained, with a slight initial decrease followed by stabilization.
Conclusions:
- Microporous membrane oxygenators are effective for extracorporeal carbon dioxide extraction in pumpless systems.
- The technology shows good biocompatibility, with minimal hemolysis and stable hematological parameters.
- This method holds promise for partial respiratory support, offering a potentially safer and less invasive approach.