Rationale: We developed an innovative, minimally invasive, highly efficient extracorporeal CO2 removal (ECCO2R) technique called respiratory electrodialysis (R-ED). Objectives: To evaluate the efficacy of R-ED in controlling ventilation compared with conventional ECCO2R technology. Methods: Five mechanically ventilated swine were connected to a custom-made circuit optimized for R-ED, consisting of a hemofilter, a membrane lung, and an electrodialysis cell. Electrodialysis regionally modulates blood electrolyte concentration to convert bicarbonate to CO2 before entering the membrane lung, enhancing membrane lung CO2 extraction. All animals underwent three repeated experimental sequences, consisting of four steps: baseline (1 h), conventionalECCO2R(2 h), R-ED (2 h), and finalNOECCO2R (1 h). Blood and gas flow were 250 ml/min and 10 L/min, respectively. Tidal volume was set at 8 ml/kg, and respiratory rate was adjusted to maintain arterial PCO2 at 50 mm Hg. Measurements and Main Results: During R-ED, chloride andH1 concentration increased in blood entering the membrane lung, almost doubling CO2 extraction compared with ECCO2R (11266 vs. 6465 ml/min, P,0.001). Compared with baseline, R-ED and ECCO2R reduced minute ventilation by 50% and 27%, respectively. Systemic arterial gas analyses remained stable during the experimental phases. No major complication occurred, but there was an increase in creatinine level. Conclusions: In this first in vivo application, we proved electrodialysis feasible and effective in increasingmembrane lung CO2 extraction. R-ED was more effective than conventional ECCO2R technology in controlling ventilation. Further studies are warranted to assess the safety profile of R-ED, especially regarding kidney function.
ZANELLA, A., CASTAGNA, L., SALERNO, D., SCARAVILLI, V., El Sayed Deab, S., MAGNI, F., et al. (2015). Respiratory electrodialysis a novel, highly efficient extracorporeal CO2 removal technique. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 192(6), 719-726 [10.1164/rccm.201502-0289OC].
|Citazione:||ZANELLA, A., CASTAGNA, L., SALERNO, D., SCARAVILLI, V., El Sayed Deab, S., MAGNI, F., et al. (2015). Respiratory electrodialysis a novel, highly efficient extracorporeal CO2 removal technique. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 192(6), 719-726 [10.1164/rccm.201502-0289OC].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Respiratory electrodialysis a novel, highly efficient extracorporeal CO2 removal technique|
|Autori:||ZANELLA, A; CASTAGNA, L; SALERNO, D; SCARAVILLI, V; El Sayed Deab, S; MAGNI, F; GIANI, M; Mazzola, S; Albertini, M; PATRONITI, N; MANTEGAZZA, F; PESENTI, A|
CASTAGNA, LUIGI (Secondo)
MANTEGAZZA, FRANCESCO (Penultimo)
PESENTI, ANTONIO MARIA (Ultimo) (Corresponding)
|Data di pubblicazione:||2015|
|Rivista:||AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1164/rccm.201502-0289OC|
|Appare nelle tipologie:||01 - Articolo su rivista|