THE INTRAVASCULAR OXYGENATOR (IVOX) - PRELIMINARY-RESULTS OF A NEW MEANS OF PERFORMING EXTRAPULMONARY GAS-EXCHANGE

被引:15
作者
GENTILELLO, LM
JURKOVICH, GJ
GUBLER, KD
ANARDI, DM
HEISKELL, R
机构
[1] Department of Surgery, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA
关键词
D O I
10.1097/00005373-199309000-00011
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Conventional management of adult respiratory distress syndrome (ARDS) with high minute ventilation, positive end-expiratory pressure (PEEP), and increased fractional inspired oxygen (FIO2) Concentrations may worsen pulmonary injury. The intravascular oxygenator (IVOX) is a device made up of several hundred gas permeable hollow fibers that are inserted into the vena cava by femoral venous cutdown. Flow of gas through each fiber adds O2 and removes CO2 from the bloodstream. The purpose of this study was to determine if the IVOX significantly reduces the level of mechanical ventilatory support in ARDS patients. The IVOX was inserted in nine patients, and aborted in one because of technical complications. The IVOX increased PaO2 and reduced PaCO2, but the quantity of gas transfer was not sufficient to allow a reduction in PEEP, FIO2, or minute ventilation. Insertion of the IVOX decreased cardiac index and systemic oxygen delivery despite maximum fluid and inotropic support. Mortality was 80%. Although some gas exchange occurs, the current device does not allow a significant reduction in the level of mechanical ventilatory support and adversely affects systemic oxygen transport.
引用
收藏
页码:399 / 404
页数:6
相关论文
共 18 条
[1]  
ASHBAUGH DG, 1967, LANCET, V2, P319
[2]   CHANGES IN LUNG VOLUME DIFFUSING CAPACITY AND BLOOD GASES IN MEN BREATHING OXYGEN [J].
CALDWELL, PR ;
LEE, WL ;
SCHILDKR.HS ;
ARCHIBAL.ER .
JOURNAL OF APPLIED PHYSIOLOGY, 1966, 21 (05) :1477-&
[3]   OXYGEN TOXICITY - THE EFFECT OF INHALATION OF HIGH CONCENTRATIONS OF OXYGEN FOR 24 HOURS ON NORMAL MEN AT SEA LEVEL AND AT A SIMULATED ALTITUDE OF 18,000 FEET [J].
COMROE, JH ;
DRIPPS, RD ;
DUMKE, PR ;
DEMING, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1945, 128 (10) :710-717
[4]   THE EFFECT OF PEEP ON CARDIAC-OUTPUT [J].
DORINSKY, PM ;
WHITCOMB, ME .
CHEST, 1983, 84 (02) :210-216
[5]   COMPARISON OF CONVENTIONAL AND HIGH-FREQUENCY VENTILATION - OXYGENATION AND LUNG PATHOLOGY [J].
HAMILTON, PP ;
ONAYEMI, A ;
SMYTH, JA ;
GILLAN, JE ;
CUTZ, E ;
FROESE, AB ;
BRYAN, AC .
JOURNAL OF APPLIED PHYSIOLOGY, 1983, 55 (01) :131-138
[6]   LOW MORTALITY ASSOCIATED WITH LOW-VOLUME PRESSURE LIMITED VENTILATION WITH PERMISSIVE HYPERCAPNIA IN SEVERE ADULT RESPIRATORY-DISTRESS SYNDROME [J].
HICKLING, KG ;
HENDERSON, SJ ;
JACKSON, R .
INTENSIVE CARE MEDICINE, 1990, 16 (06) :372-377
[7]   VENTILATORY MANAGEMENT OF ARDS - CAN IT AFFECT THE OUTCOME [J].
HICKLING, KG .
INTENSIVE CARE MEDICINE, 1990, 16 (04) :219-226
[8]   PROLONGED EXTRACORPOREAL OXYGENATION FOR ACUTE POSTTRAUMATIC RESPIRATORY FAILURE (SHOCK-LUNG SYNDROME) - USE OF BRAMSON MEMBRANE LUNG [J].
HILL, JD ;
BRAMSON, ML ;
GERBODE, F ;
OSBORN, JJ ;
OBRIEN, TG ;
DONTIGNY, L ;
MURRAY, JJ .
NEW ENGLAND JOURNAL OF MEDICINE, 1972, 286 (12) :629-&
[9]  
KOLOBOW T, 1987, AM REV RESPIR DIS, V135, P312
[10]   INVIVO LUNG LAVAGE AS AN EXPERIMENTAL-MODEL OF THE RESPIRATORY-DISTRESS SYNDROME [J].
LACHMANN, B ;
ROBERTSON, B ;
VOGEL, J .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1980, 24 (03) :231-236