Efficacy and safety of lower versus higher CO 2 extraction devices to allow ultraprotective ventilation: secondary analysis of the SUPERNOVA study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Thorax Année : 2019

Efficacy and safety of lower versus higher CO 2 extraction devices to allow ultraprotective ventilation: secondary analysis of the SUPERNOVA study

Tommaso Tonetti
  • Fonction : Auteur
Vito Fanelli
  • Fonction : Auteur
Tai Pham
Antonio Pesenti
  • Fonction : Auteur
Jordi Mancebo
  • Fonction : Auteur
Daniel Brodie
  • Fonction : Auteur
V Marco Ranieri
  • Fonction : Auteur

Résumé

Retrospective analysis of the SUPERNOVA trial exploring the hypothesis that efficacy and safety of extracorporeal carbon dioxide removal (ECCO 2 R) to facilitate reduction of tidal volume (V T ) to 4 mL/kg in patients with acute respiratory distress syndrome (ARDS) may differ between systems with lower (area of membrane length 0.59 m 2 ; blood flow 300–500 mL/min) and higher (membrane area 1.30 m 2 ; blood flow between 800 and 1000 mL/min) CO 2 extraction capacity. Ninety-five patients with moderate ARDS were included (33 patients treated with lower and 62 patients treated with higher CO 2 extraction devices). We found that (1) V T of 4 mL/kg was reached by 55% and 64% of patients with the lower extraction versus 90% and 92% of patients with higher extraction devices at 8 and 24 hours from baseline, respectively (p<0.001), and (2) percentage of patients experiencing episodes of ECCO 2 R-related haemolysis and bleeding was higher with lower than with higher extraction devices (21% vs 6%, p=0.045% and 27% vs 6%, p=0.010, respectively). Although V T of 4 mL/kg could have been obtained with all devices, this was achieved frequently and with a lower rate of adverse events by devices with higher CO 2 extraction capacity.

Dates et versions

hal-03997142 , version 1 (20-02-2023)

Identifiants

Citer

Alain Combes, Tommaso Tonetti, Vito Fanelli, Tai Pham, Antonio Pesenti, et al.. Efficacy and safety of lower versus higher CO 2 extraction devices to allow ultraprotective ventilation: secondary analysis of the SUPERNOVA study. Thorax, 2019, 74 (12), pp.1179-1181. ⟨10.1136/thoraxjnl-2019-213591⟩. ⟨hal-03997142⟩
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