Extracorporeal blood flow: as high as necessary, as low as possible.
- In addition to or as an alternative to ventilation strategies providing lung protection – enables (ultra)protective ventilation
- Up to 25% of CO2 production can be removed. The lung is given time to heal.
- In a similar way to renal replacement therapy, extrapulmonary partial CO2 removal requires low blood flow rates and relatively small cannulas. The effectiveness of CO2 removal is primarily controlled by the flow rate of the sweepgas and depends on the CO2 partial pressure gradient.
- Under mechanical ventilation, the breathing muscles begin to degenerate within a very short space of time (Ventilator Induced Diaphragm Dysfunction, VIDD)
- Support weaning
- Avoid intubation in borderline indications
Partial CO2 removal with blood flows <800ml/min
- Supports gas exchange and compensates failure of the breathing pump.Up to 25% of CO2 production can be removed5.The lung is given time to heal.
- Supports oxygenation by simply increasing the extrapulmonary blood flow
- Avoiding of intubation in case of intolerance to NIV
- Shortening of IMV duration where intubation was unavoidable
- Enabling and accelerating weaning from IMV
- Reduction of analgo sedation
- Reduction of tube-associated side effects (VALI/ VILI/VAP/VIDD).
- Reduction of breathing load
- Compensation of breathing pump failure through partial adoption of pulmonary function
CO2 removal and oxygenation with blood flows of 800-3000 ml/min
- Dependable maintenance of gas exchange and lower mortality in severe lung failure through veno-venous extrapulmonary gas exchange
- Reduction in mortality by 50% in severe H1N1 influenza A infections.6
- Immediate improvement in oxygenation and rapid correction of hypoxemia
- Short-term support by means of extracorporeal gas exchange in patients with acute, reversible respiratory failure
- “Bridge to transplant” in patients with irreversible respiratory failure
- For patients where oxygenation or ventilation is difficult to maintain using conventional lungprotective ventilation.7,8
- To gain valuable time so that adjuvant therapies (e.g., antibiotics) can start to work and lung function can recover.8
5 Terragni P et.al. Curr Opin Crit Care 2012 Feb; 18(1):93-98.
6 Noah MA et al. JAMA 2011; 306(15):1659-1668.
7 Tiruvoipati R et al. J Crit Care 2012; 27(2):192-198.
8 Peek GJ et al. Lancet 2009; 374(9698):1351-1363.