• Anaesth Crit Care Pain Med · Jun 2015

    Novel CO2 removal device driven by a renal-replacement system without hemofilter. A first step experimental validation.

    • Thomas Godet, Alain Combes, Elie Zogheib, Matthieu Jabaudon, Emmanuel Futier, Arthur S Slutsky, and Jean-Michel Constantin.
    • General Intensive Care Unit, réanimation adultes et unité de soins continus, département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, université Auvergne - Clermont-Ferrand 1, 63000 Clermont-Ferrand, France. Electronic address: tgodet@chu-clermontferrand.fr.
    • Anaesth Crit Care Pain Med. 2015 Jun 1; 34 (3): 135-40.

    ObjectivesTo study the technical effectiveness of a novel extracorporeal CO2 removal device in removing CO2 from blood.Study DesignProspective animal study.AnimalsFive adult female healthy pigs.MethodsHypercapnic pigs were equipped with a low-flow CO2 removal device (PrismaLung(®), Hospal(®)) integrated on a CRRT platform. The rate of CO2 elimination was examined in vivo using a hollow fiber gas exchanger under various conditions (blood flow rates: 200, 300 and 400 mL/min; sweep gas flows: 2, 5, 10 and 50 L/min; FsO2: 0.21 and 1). Statistical analysis was performed with Student t-test.ResultsThe extracorporeal device produced CO2 removal rates ranging from 35 to 75 mL/min. Efficiency was increased with higher blood and sweep gas flows: reduction of PCO2 of 40.2 ± 13.0 mmHg (relative decrease of 46%, P < 0.001) and increase in pH of 0.24 ± 0.06 (7.21 before and 7.46 after filter, P < 0.001). Animals' blood gases were significantly modified after 10 minutes of treatment: PaCO2 decreased from 81.2 to 70.0 mmHg (relative decrease of 14%, P < 0.001) and pH increased from 7.17 to 7.22 (P < 0.001). No significant changes in arterial blood oxygenation were observed when using pure oxygen (increase of PaO2 from 106 to 107 mmHg, P = 0.36), allowing the use of ambient air as sweep gas through the membrane.ConclusionsA device based on a Prismaflex(®) platform was technically effective in removing CO2 from the blood, thus decreasing PaCO2 and acidosis in hypercapnic pigs.Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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