Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure

L. Gattinoni, A. Pesenti, D. Mascheroni, R. Marcolin, R. Fumagalli, F. Rossi, G. Iapichino, G. Romagnoli, L. Uziel, A. Agostoni

Research output: Contribution to journalArticle

Abstract

Forty-three patients were entered in an uncontrolled study designed to evaluate extracorporeal membrane lung support in severe acute respiratory failure of parenchymal origin. Most of the metabolic carbon dioxide production was cleared through a low-flow venovenous bypass. To avoid lung injury from conventional mechanical ventilation, the lungs were kept 'at rest' (three to five breaths per minute) at a low peak airway pressure of 35 to 45 cm H2O (3.4 to 4.4 kPa). The entry criteria were based on gas exchange under standard ventilatory conditions (expected mortality rate, > 90%). Lung function improved in thirty-one patients (72.8%), and 21 patients (48.8%) eventually survived. The mean time on bypass for the survivors was 5.4 ± 3.5 days. Improvement in lung function, when present, always occurred within 48 hours. Blood loss averaged 1800 ± 850 mL/d. No major technical accidents occurred in more than 8000 hours of perfusion. Extracorporeal carbon dioxide removal with low-frequency ventilation proved a safe technique, and we suggest it as a valuable tool and an alternative to treating severe acute respiratory failure by conventional means.

Original languageEnglish
Pages (from-to)881-886
Number of pages6
JournalJournal of the American Medical Association
Volume256
Issue number7
DOIs
Publication statusPublished - 1986

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Positive-Pressure Respiration
Respiratory Insufficiency
Lung
Carbon Dioxide
Lung Injury
Artificial Respiration
Accidents
Ventilation
Survivors
Perfusion
Gases
Pressure
Membranes
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gattinoni, L., Pesenti, A., Mascheroni, D., Marcolin, R., Fumagalli, R., Rossi, F., ... Agostoni, A. (1986). Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. Journal of the American Medical Association, 256(7), 881-886. https://doi.org/10.1001/jama.256.7.881

Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. / Gattinoni, L.; Pesenti, A.; Mascheroni, D.; Marcolin, R.; Fumagalli, R.; Rossi, F.; Iapichino, G.; Romagnoli, G.; Uziel, L.; Agostoni, A.

In: Journal of the American Medical Association, Vol. 256, No. 7, 1986, p. 881-886.

Research output: Contribution to journalArticle

Gattinoni, L, Pesenti, A, Mascheroni, D, Marcolin, R, Fumagalli, R, Rossi, F, Iapichino, G, Romagnoli, G, Uziel, L & Agostoni, A 1986, 'Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure', Journal of the American Medical Association, vol. 256, no. 7, pp. 881-886. https://doi.org/10.1001/jama.256.7.881
Gattinoni, L. ; Pesenti, A. ; Mascheroni, D. ; Marcolin, R. ; Fumagalli, R. ; Rossi, F. ; Iapichino, G. ; Romagnoli, G. ; Uziel, L. ; Agostoni, A. / Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. In: Journal of the American Medical Association. 1986 ; Vol. 256, No. 7. pp. 881-886.
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