Update on the Role of Extracorporeal CO2 Removal as an Adjunct to Mechanical Ventilation in ARDS
Abstract
Despite new promising therapeutic interventions including protective ventilation, prone positioning, use of neuromuscular blockers and conservative fluid balance, acute respiratory distress syndrome (ARDS) remains a devastating disease. Mortality rates for ARDS have decreased over time but still remain around 40%, in large part a result of the hemodynamic complications of this syndrome. ARDS has various etiologies and early diagnosis and intervention are key to improving outcomes. Dominant features of ARDS include injury to the alveolar-capillary membrane, which results in severe hypoxemia, decrease in pulmonary compliance, and increase in pulmonary vascular resistance. At present, positive-pressure mechanical ventilation is the mainstay of symptomatic treatment for ARDS, but may further increase pulmonary hypertension and right ventricular (RV) afterload, leading to acute corpulmonale and RV failure. Moreover, mechanical ventilation induces additional lung injuries due to overdistention, repeated stretch to the alveoli, atelectotrauma, and increased inflammatory mediator levels.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 16, 2015
- Accession Number
- ADA620382
Entities
People
- Andriy I. Batchinsky
- Bernard Lambermont
- Philippe Morimont
Organizations
- United States Army Institute of Surgical Research