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[Hemodynamic improvement during therapy using the intravascular oxygenator (IVOX)]

H M Vonwiller1, L von Segesser, A Schaffner

  • 1Department für Innere Medizin, Universitätsspital Zürich.

Schweizerische Medizinische Wochenschrift
|March 20, 1993
PubMed
Summary

An intravascular oxygenator (IVOX) successfully treated a young patient with severe pneumonia and shock. This novel device improved oxygenation and cardiovascular function, enabling recovery.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Biomedical Engineering

Background:

  • Severe pneumonia and sepsis can lead to acute respiratory distress and cardiovascular compromise.
  • Mechanical ventilation with high oxygen levels and PEEP may be insufficient in critical cases.
  • The intravascular oxygenator (IVOX) is an innovative device designed for blood oxygenation and CO2 removal within the vena cava.

Observation:

  • A 21-year-old female presented with severe hypoxia and shock secondary to pneumococcal pneumonia and sepsis.
  • Mechanical ventilation parameters (FiO2 1.0, PEEP 13 mbar) were optimized but insufficient.
  • An intravascular oxygenator was implanted in the superior and inferior vena cava.

Findings:

  • The IVOX implantation led to rapid improvement in blood oxygenation.

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  • Cardiovascular function improved significantly, evidenced by increased mean arterial pressure and mixed-venous saturation.
  • The need for vasopressor support decreased, and the IVOX was safely used for 29 days.
  • The patient was successfully weaned from mechanical ventilation and discharged after 99 days.

    • Implications:

    • The intravascular oxygenator presents a promising therapeutic option for severe respiratory failure and associated shock.
    • This case highlights the potential of novel extracorporeal devices in managing critical cardiorespiratory conditions.
    • Further research into IVOX efficacy and safety in broader patient populations is warranted.