Feasibility and safety of low-flow extracorporeal CO₂ removal managed with a renal replacement platform to enhance lung-protective ventilation of patients with mild-to-moderate ARDS.

ABSTRACT:

Background

Extracorporeal carbon-dioxide removal (ECCO₂R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (P_plat) (< 30 cmH₂O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO₂R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS).

Methods

Twenty patients with mild (n = 8) or moderate (n = 12) ARDS were included. VT was gradually lowered from 6 to 5, 4.5, and 4 ml/kg, and PEEP adjusted to reach 23 ≤ P_plat ≤ 25 cmH₂O. Stand

SUBMITTER: Schmidt M 

PROVIDER: S-EPMC5944133 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature