Extracorporeal Support in Acute Respiratory Failure

  • L. Gattinoni
  • A. Pesenti
  • R. Marcolin
  • D. Mascheroni
  • R. Fumagalli
  • A. Riboni
  • F. Rossi
  • F. Scarani
  • L. Avalli
  • A. Giuffrida
Part of the Current Concepts in Critical Care book series (CRITICAL CARE)

Abstract

Following the introduction of the membrane lung into clinical practice it was appealing to use this device as a substitute for alveolar capillary function in severe acute respiratory failure (ARF). Conventional treatment by positive pressure ventilation does not, in fact, substitute for respiratory function, but maximally exploits the residual gas-exchanging regions of the diseased lungs. Hill et al. (dy1972) reported the first successful clinical application of the membrane lung in the treatment of ARF but, from 1966 to 1975, only a 10% survival rate was obtained in 233 cases treated worldwide (Gille and Bagniewski 1976).

Keywords

Surfactant Toxicity Catheter Dioxide Pneumonia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Berman LS, Downs JB, Van Feden A et al. (1981) Inspiration-expiration ratio. Is mean airways pressure the difference? Crit Care Med 9:775–777.PubMedCrossRefGoogle Scholar
  2. Boros SJ (1979) Variations in inspiratory-expiratory ratio and airway pressure wave form during mechanical ventilation: the significance of mean airway pressure. J Pediatr 94:114–117.PubMedCrossRefGoogle Scholar
  3. Brismar B, Hedenstierna G, Lundquist H et al. (1985) Pulmonary densities during anesthesia with muscular relaxation. A proposal of atelectasis. Anesthesiology 62:422–428.Google Scholar
  4. Dantzker DR, Brook JC, Dehart P et al. (1979) Ventilation-perfusion distributions in the adult respiratory distress syndrome. Am Rev Respir Dis 120:1039–1042.PubMedGoogle Scholar
  5. Deneke SM, Fanburg BL (1982) Oxygen toxicity of the lung: an update. Br J Anaesthesiol 54:737–749.CrossRefGoogle Scholar
  6. Dreyfuss D, Basset G, Soler P et al. (1985) Intermittent positive pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Am Rev Respir Dis 132:880–884.PubMedGoogle Scholar
  7. Gattinoni L, Agostoni A, Pesenti A et al. (1980) Treatment of acute respiratory failure with low frequency positive pressure ventilation and extracorporeal CO2 removal. Lancet II 292–294.CrossRefGoogle Scholar
  8. Gattinoni L et al. (1982) La compliance toraco-polmonare: metodi di misura, significato clinico, implicazioni terapeutiche. In: Atti Corso Agg. Spec. in Rianimazione e Terapia Intensiva, Pavia, pp 89–104.Google Scholar
  9. Gattinoni L, Pesenti A, Kolobow T et al. (1983) A new look at therapy of the adult respiratory distress syndrome: motionless lungs. Int Anaesthesiol Clin 21(2):97–117.CrossRefGoogle Scholar
  10. Gattinoni L, Pesenti A, Caspani ML et al. (1984) The role of total static lung compliance in the management of severe ARDS unresponsive to conventional treatment. Intensive Care Med 10:121–126.PubMedCrossRefGoogle Scholar
  11. Gattinoni L, Marcolin R, Caspani ML et al. (1985) Constant mean airway pressure with different patterns of positive pressure breathing during the adult respiratory distress syndrome. Clin Respir Physiol 21:275–279.Google Scholar
  12. Gattinoni L, Mascheroni D, Torresin A, Marcolin R et al. (1986) Morphological response to positive end expiratory pressure in acute respiratory failure: computerized tomography study. Intensive Care Med 12:137–142.PubMedCrossRefGoogle Scholar
  13. Gille JP, Bagniewski A (1976) Ten years of use of extracorporeal membrane oxygenation (ECMO) in treatment of acute respiratory insufficiency. Trans Am Soc Artif Intern Organs 22:102–108.PubMedGoogle Scholar
  14. Hill JD, O’Brien TG, Murray JT (1972) Prolonged extracorporeal oxygenation for acute post traumatic respiratory failure (shock-lung syndrome). N Engl J Med 286:629–634.PubMedCrossRefGoogle Scholar
  15. Kolobow T, Spragg R, Pierce J (1981) Massive pulmonary infarction during total cardiopulmonary bypass in unanesthetized spontaneously breathing lambs. Int J Artif Organs 4:76–81.PubMedGoogle Scholar
  16. Kolobow T, Moretti M, Fumagalli R et al. (1985) Adult respiratory distress syndrome following mechanical pulmonary ventilation at high peak airway pressures. Am Rev Respir Dis 131S:137A.Google Scholar
  17. Lemaire F et al. (1984) Total respiratory pressure-volume curve in the Adult Respiratory Distress Syndrome. Chest 86:58–66.PubMedCrossRefGoogle Scholar
  18. Mascheroni D, Kolobow T, Fumagalli R et al. (1985) Respiratory failure following induced hyperventilation. An experimental study. Crit Care Med 13:330.Google Scholar
  19. NHLI (1974) Protocol for extracorporeal support for respiratory insufficiency. Collaborative Program, National Heart and Lung Institutes, Division of Lung Diseases, 15 May 1974.Google Scholar
  20. Pesenti A, Pelizzola A, Mascheroni D et al. (1981) Low frequency positive pressure ventilation with extracorporeal CO2 removal (LFPPV-ECCO2R) in acute respiratory failure (ARF): technique. Trans Am Soc Artif Intern Organs 27:263–266.PubMedGoogle Scholar
  21. Ratliff JL, Hill JD, Fallat RJ et al. (1975) Complications associated with membrane lung support by venoarterial perfusion. Ann Thorac Surg 19:537–539.PubMedCrossRefGoogle Scholar
  22. Suter MP, Fairley HB, Isemberg MD (1978) Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest 73:158–162.PubMedCrossRefGoogle Scholar
  23. Webb H, Tierney DF (1974) Experimental pulmonary oedema due to intermittent positive pressure ventilation with high inflation pressures. Protection by positive end-expiratory pressure. Am Rev Respir Dis 110:556–565.PubMedGoogle Scholar
  24. Woodring JH (1985) Pulmonary interstitial emphysema in the adult respiratory distress syndrome. Crit Care Med 13:786–791.PubMedCrossRefGoogle Scholar
  25. Wyszogrodsky I, Kyei-Aboagye K, Taensch HWJR et al. (1975) Surfactant inactivation by hyperventilation: conservation by end-expiratory pressure. J Appl Physiol 38:461–466.Google Scholar
  26. Zapol WM, Snider MT, Hill JD et al. (1979) Extracorporeal membrane lung oxygenation in severe acute respiratory failure. JAMA 242:2193–2196.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • L. Gattinoni
  • A. Pesenti
  • R. Marcolin
  • D. Mascheroni
  • R. Fumagalli
  • A. Riboni
  • F. Rossi
  • F. Scarani
  • L. Avalli
  • A. Giuffrida

There are no affiliations available

Personalised recommendations