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Related Concept Videos

Loss of Carboxy Group as CO2: Decarboxylation of β-Ketoacids01:02

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Carboxylic acids, upon heating, undergo a decarboxylation reaction by releasing carbon dioxide gas. Monocarboxylic acids do not undergo decarboxylation easily. However, a silver salt of carboxylic acid reacts with bromine or iodine under high temperature to release carbon dioxide gas and forms halide with one less carbon. This reaction is called the Hunsdiecker reaction.
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Loss of Carboxy Group as CO2: Decarboxylation of Malonic Acid Derivatives01:35

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Just like β-keto acids—which upon thermal decarboxylation form ketones—β-dicarboxylic acids undergo decarboxylation to generate monocarboxylic acids with the liberation of carbon dioxide.
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Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

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Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
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Electrical Current01:10

Electrical Current

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Electrical current is defined as the rate at which charge flows. When there is a large current present, such as that used to run a refrigerator, a large amount of charge moves through the wire in a small amount of time. If the current is small, such as that used to operate a handheld calculator, a small amount of charge moves through the circuit over a long period of time. The SI unit for current is the ampere (A), named for the French physicist André-Marie Ampère (1775–1836).
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Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Significance of Displacement Current01:27

Significance of Displacement Current

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A displacement current is analogous to a real current in Ampère's law, participating in Ampère's law the same way as the usual conduction current. However, it is produced by a changing electric field. Displacement current is defined in terms of a time-varying electric field, and also has an associated displacement current density. By adding a term accounting for displacement current, Maxwell modified the existing Ampère's law, which is now called generalized Ampère's law.
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Light-driven Enzymatic Decarboxylation
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[Current techniques for extracorporeal decarboxylation].

J Nentwich1, S John2

  • 1Abteilung Internistische Intensivmedizin, Medizinische Klinik 8, Paracelsus Medizinische Privatuniversität Nürnberg & Universität Erlangen-Nürnberg, Klinikum Nürnberg-Süd, 90473, Nürnberg, Deutschland.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|April 26, 2019
PubMed
Summary
This summary is machine-generated.

Extracorporeal CO2 removal (ECCO2R) systems offer less invasive ways to manage respiratory failure by removing CO2. While reducing ventilator-induced lung injury, their impact on patient survival remains unproven, warranting cautious use.

Keywords:
ARDSExtracorporeal CO2 eliminationExtracorporeal lung assistHypercapniaLung protection

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Area of Science:

  • Critical Care Medicine
  • Respiratory Physiology
  • Cardiopulmonary Support

Background:

  • Extracorporeal lung assist (ECLA) has led to diverse decarboxylation systems.
  • Low extracorporeal blood flows enable effective CO2 removal with reduced invasiveness.
  • Emerging therapies utilize renal replacement platforms for respiratory support ('respiratory dialysis').

Purpose of the Study:

  • To review the current landscape of extracorporeal CO2 elimination (ECCO2R) systems.
  • To discuss the application of ECCO2R in managing acute respiratory failure and ARDS.
  • To evaluate the clinical evidence and current recommendations for ECCO2R use.

Main Methods:

  • Review of clinical practice and emerging technologies in ECCO2R.
  • Analysis of system capabilities for CO2 transport and respiratory acidosis control.
  • Evaluation of studies investigating ECCO2R's impact on ventilator-induced lung injury (VILI) and clinical outcomes.

Main Results:

  • Low-flow ECCO2R systems effectively eliminate CO2, aiding in respiratory acidosis management and enabling protective ventilation.
  • ECCO2R has demonstrated a reduction in ventilator-induced lung injury (VILI).
  • Positive effects on hard clinical endpoints like mortality and duration of mechanical ventilation are not yet proven.

Conclusions:

  • ECCO2R, particularly low-flow systems, shows promise in managing acute lung failure and facilitating lung-protective ventilation.
  • Despite reducing VILI, the clinical benefits of ECCO2R on mortality and ventilation duration require further investigation.
  • Given the limited evidence, ECCO2R should be considered experimental and used only in experienced centers.