Hemodynamic, mechanical and renal effects during 'apneic oxygenation' with extracorporeal carbon dioxide removal, at different levels of intrapulmonary pressure in lambs

L. Gattinoni, G. Iapichino, T. Kolobow

Research output: Contribution to journalArticle

Abstract

It has been shown that apneic oxygenation can be safely performed for many days when metabolic carbon dioxide is removed by an extracorporeal membrane lung, and 100% oxygen is supplied directly into the trachea to keep the intrapulmonary pressure at 5 cm. H2O. The study was designed to find 'best intrapulmonary pressure (IP)', analogous to 'best PEEP' during continuous positive pressure ventilation. In the present study we have shown that when IP was progressively raised from 5 cm H2O to 20 cm H2O the PaO2 rose significantly due to progressive decrease in ̇Q(VA)/̇Q. A linear positive correlation was found between CO and ̇Q(VA)/̇Q. There was a negative correlation between ̇Q(VA)/̇Q and FRC. Total static lung compliance and FRC increased significantly at 15-20 cm H2O IP. There was no significant change in urinary flow, urea and creatinine clearances. We conclude that in apneic oxygenation a more 'optimal IP' is attained at an IP pressure of 20 cm H2O than at 5 cm H2O.

Original languageEnglish
Pages (from-to)249-253
Number of pages5
JournalInternational Journal of Artificial Organs
Volume2
Issue number5
Publication statusPublished - 1979

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Oxygenation
Hemodynamics
Carbon Dioxide
Carbon dioxide
Kidney
Pressure
Lung Compliance
Positive-Pressure Respiration
Carbon Monoxide
Trachea
Urea
Creatinine
Ventilation
Oxygen
Lung
Membranes

ASJC Scopus subject areas

  • Biophysics

Cite this

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title = "Hemodynamic, mechanical and renal effects during 'apneic oxygenation' with extracorporeal carbon dioxide removal, at different levels of intrapulmonary pressure in lambs",
abstract = "It has been shown that apneic oxygenation can be safely performed for many days when metabolic carbon dioxide is removed by an extracorporeal membrane lung, and 100{\%} oxygen is supplied directly into the trachea to keep the intrapulmonary pressure at 5 cm. H2O. The study was designed to find 'best intrapulmonary pressure (IP)', analogous to 'best PEEP' during continuous positive pressure ventilation. In the present study we have shown that when IP was progressively raised from 5 cm H2O to 20 cm H2O the PaO2 rose significantly due to progressive decrease in ̇Q(VA)/̇Q. A linear positive correlation was found between CO and ̇Q(VA)/̇Q. There was a negative correlation between ̇Q(VA)/̇Q and FRC. Total static lung compliance and FRC increased significantly at 15-20 cm H2O IP. There was no significant change in urinary flow, urea and creatinine clearances. We conclude that in apneic oxygenation a more 'optimal IP' is attained at an IP pressure of 20 cm H2O than at 5 cm H2O.",
author = "L. Gattinoni and G. Iapichino and T. Kolobow",
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AU - Gattinoni, L.

AU - Iapichino, G.

AU - Kolobow, T.

PY - 1979

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N2 - It has been shown that apneic oxygenation can be safely performed for many days when metabolic carbon dioxide is removed by an extracorporeal membrane lung, and 100% oxygen is supplied directly into the trachea to keep the intrapulmonary pressure at 5 cm. H2O. The study was designed to find 'best intrapulmonary pressure (IP)', analogous to 'best PEEP' during continuous positive pressure ventilation. In the present study we have shown that when IP was progressively raised from 5 cm H2O to 20 cm H2O the PaO2 rose significantly due to progressive decrease in ̇Q(VA)/̇Q. A linear positive correlation was found between CO and ̇Q(VA)/̇Q. There was a negative correlation between ̇Q(VA)/̇Q and FRC. Total static lung compliance and FRC increased significantly at 15-20 cm H2O IP. There was no significant change in urinary flow, urea and creatinine clearances. We conclude that in apneic oxygenation a more 'optimal IP' is attained at an IP pressure of 20 cm H2O than at 5 cm H2O.

AB - It has been shown that apneic oxygenation can be safely performed for many days when metabolic carbon dioxide is removed by an extracorporeal membrane lung, and 100% oxygen is supplied directly into the trachea to keep the intrapulmonary pressure at 5 cm. H2O. The study was designed to find 'best intrapulmonary pressure (IP)', analogous to 'best PEEP' during continuous positive pressure ventilation. In the present study we have shown that when IP was progressively raised from 5 cm H2O to 20 cm H2O the PaO2 rose significantly due to progressive decrease in ̇Q(VA)/̇Q. A linear positive correlation was found between CO and ̇Q(VA)/̇Q. There was a negative correlation between ̇Q(VA)/̇Q and FRC. Total static lung compliance and FRC increased significantly at 15-20 cm H2O IP. There was no significant change in urinary flow, urea and creatinine clearances. We conclude that in apneic oxygenation a more 'optimal IP' is attained at an IP pressure of 20 cm H2O than at 5 cm H2O.

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