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Extracorporeal CO2-removal with a heparin coated artificial lung

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Treatment of severe acute respiratory failure with extracorporeal gas exchange necessitating near complete systemic anticoagulation requires a delicate balance to be maintained between disseminated intravascular coagulation and hemorrhagic complications. The present study describes our first experience using a heparin coated extracorporeal artificial lung and circuitry during clinical extracorporeal CO2 removal. In spite of a partial thromboplastin time and activated clotting time within or close to the normal range, neither laboratory evidence for disseminated intravascular coagulation induced by the extracorporeal circuit nor thrombi in the pulmonary vasculature were found. Scanning electron microscopy of the heparin coated hollow fiber gas exchanger demonstrated only minor deposits on the surface. Use of a heparin coated artificial lung may enhance the margin of safety of extracorporeal gas exchange and ultimately broaden its indications.

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  1. Barthels M, Poliwoda H (1987) Gerinnungsanalysen. Thieme, New York

    Google Scholar 

  2. Bindslev L, Gouda I, Inacio J, Kodama K, Lagergren H, Larm O, Nilsson E, Olsson P (1986) Extracorporeal elimination of carbon dioxid using a surface-heparinized veno-venous bypass system. Trans Am Soc Artif Intern Organs 32:530

    Article  CAS  Google Scholar 

  3. Bindslev L, Eklund J, Norlander O, Swedenborg J, Olsson P, Nilsson E, Larm O, Gouda I, Malmberg A, Scholander E (1987) Treatment of acute respiratory failure by extracorporeal carbon dioxid elimination performed with a surface heparinized artificial lung. Anesthesiology 67:117

    Article  CAS  Google Scholar 

  4. Chenoweth DE, Cooper SW, Hugli TE, Stewart RW, Blackstone EH, Kirklin JW (1981) Complement activation during cardiopulmonary bypass. N Engl J Med 304:497

    Article  CAS  Google Scholar 

  5. Gattinoni L, Agostini A, Damia G, Cantaluppi D, Bernasconi C, Tarenzi L, Pelizzola A, Rossi GP (1980) Hemodynamics and renal function during low frequency positive pressure ventilation with extracorporeal CO2 removal. Intensive Care Med 6:155

    Article  CAS  Google Scholar 

  6. Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F, Iapichino G, Romagnoli G, Uziel L, Agostini A, Kolobow T, Damia G (1986) Low-frequency positive pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA 256:881

    Article  CAS  Google Scholar 

  7. Handin RI (1987) Coagulation disorders. In: Braunwald E, Isselbacher KJ, Petersdorf RG, Wilson JD, Martin JB, Fauci AS (eds) Principles of internal medicine. McGraw-Hill, New York, p 1475

    Google Scholar 

  8. Kolobow T, Zapol WM, Sigman RL, Pierce J (1970) Partial cardiopulmonary bypass lasting up to seven days in alert lambs with membrane lung blood oxygenation. J Thorac Cardiovasc Surg 60:781

    CAS  PubMed  Google Scholar 

  9. Larm O, Larsson R, Olsson P (1983) A new non-thrombogenic surface prepared by selective covalent binding of heparin via a modified reducing terminal residue. Biomater Med Devices Art Organs 2:161

    Article  Google Scholar 

  10. Leval M de, Hill JD, Mielke H, Bramson ML, Smith C, Gerbode F (1972) Platelet kinetics during extracorporeal circulation. Trans Am Soc Artif Int Organs 28:355

    Article  Google Scholar 

  11. Peters J, Radermacher P, Pesenti A, Schulte HD, Falke KJ (1985) Tracheal and alveolar gas composition during low-frequency positive pressure ventilation with extracorporeal CO2-removal (LFPPV-ECCO2R). Intensive Care Med 11:213

    Article  CAS  Google Scholar 

  12. Peters J, Radermacher P, Lehnsen U, Lohe B, Rösen P, Falke KJ (1987) Lung extravascular thermal volume during venovenous bypass with extracorporeal CO2-removal in dogs. Intensive Care Med 14:123

    Google Scholar 

  13. Peterson MB, Hüttemeier PC, Zapol WM, Martin EG, Watkins WD (1982) Thromboxane mediates acute pulmonary hypertension in sheep extracorporeal perfusion. Am J Physiol 243:H471

    CAS  PubMed  Google Scholar 

  14. Rosenbauer KA, Herzer JA, Kojimahara M, Falke KJ, Jansen B, Schulte HD, Bircks W (1976) Langzeitperfusionen im Tierversuch unter Anwendung beschichteter und unbeschichteter extrakoporaler Kreislaufsysteme. GIT-Fachz Lab 7:815–820

    Google Scholar 

  15. Spragg RG, Hill RN, Wedel MK, Masterson A, Moser KM (1975) Platelet kinetics in venovenous membrane oxygenation. Trans Am Soc Artif Int Organs 21:171

    CAS  Google Scholar 

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Peters, J., Radermacher, P., Kuntz, M.E. et al. Extracorporeal CO2-removal with a heparin coated artificial lung. Intensive Care Med 14, 578–584 (1988).

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