title: Pumpless extracorporeal removal of carbon dioxide combined with ventilation using low tidal volume and high positive end-expiratory pressure in a patient with severe acute respiratory distress syndrome.
abstract: The effects of the combination of a 'lowest' lung ventilation with extracorporeal elimination of carbon dioxide by interventional lung assist are described in a patient presenting with severe acute respiratory distress syndrome due to fulminant pneumonia. Reducing tidal volume to 3 ml.kg(-1) together with interventional lung assist resulted in a decrease in severe hypercapnia without alveolar collapse or hypoxaemia but with a decrease in serum levels of interleukin-6. This approach was applied for 12 days with recovery of the patient, without complications. Extracorporeal removal of carbon dioxide by interventional lung assist may be a useful tool to enable 'ultraprotective' ventilation in severe acute respiratory distress syndrome.
authors.affiliation: Department of Anaesthesia & Intensive Care, University Hospital of Regensburg, Regensburg, Germany. thomas.bein@klinik.uni-regensburg.de
authors.forename: T
authors.initials: T
authors.lastname: Bein
authors.forename: M
authors.initials: M
authors.lastname: Zimmermann
authors.forename: K
authors.initials: K
authors.lastname: Hergeth
authors.forename: M
authors.initials: M
authors.lastname: Ramming
authors.forename: L
authors.initials: L
authors.lastname: Rupprecht
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: A S
authors.initials: AS
authors.lastname: Slutsky
mesh_terms: D002245:Carbon Dioxide / Q000097:blood; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000628:therapy*; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen