title: Effect of extracorporeal CO2 removal on right ventricular and hemodynamic parameters in a patient with acute respiratory distress syndrome.
abstract: We present a female patient with severe acute respiratory distress syndrome (ARDS) necessitating intubation and mechanical ventilation on the intensive care unit (ICU). High ventilatory pressures were needed because of hypoxia and severe hypercapnia with respiratory acidosis, resulting in right ventricular dysfunction with impaired haemodynamic stability. A veno-venous extracorporeal CO2 removal (ECCO2R) circuit was initiated, effectively eliminating carbon dioxide while improving oxygenation and enabling a reduction in applied ventilatory pressures. We noted a marked improvement of right ventricular function with restoration of haemodynamic stability. Within one week, the patient was weaned from both ECCO2R and mechanical ventilation. Besides providing adequate gas exchange, extracorporeal assist devices may be helpful in ameliorating right ventricular dysfunction during ARDS.
authors.affiliation: Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands t.g.cherpanath@amc.uva.nl.
authors.forename: Thomas G V
authors.initials: TG
authors.lastname: Cherpanath
authors.affiliation: Department of Intensive Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Pearl P
authors.initials: PP
authors.lastname: Landburg
authors.affiliation: Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Wim K
authors.initials: WK
authors.lastname: Lagrand
authors.affiliation: Laboratory of Experimental Intensive Care and Anaesthesiology (LEICA), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
authors.affiliation: Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Juffermans
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000097:blood*; D005112:Extracorporeal Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D016278:Ventricular Function, Right
chemical_list: D002245:Carbon Dioxide
keywords: acute respiratory distress syndrome; extracorporeal CO2 removal; lung support; right ventricle; veno-venous