Evaluation of CO 2 removal rate of ECCO 2 R for a renal replacement therapy platform in an experimental setting

• Published in: Artificial organs 2024-06, Vol.48 (6), p.586-594
• Main Authors: Qian, Zhicheng, He, Hao, Wang, Yuxuan, Geng, Shike, Li, Yang, Yuan, Xueyan, Zhang, Rui, Yang, Yi, Qiu, Haibo, Liu, Songqiao, Liu, Ling
• Format: Article
• Language: English
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14718

A critical parameter of extracorporeal CO removal (ECCO R) applications is the CO removal rate (VCO ). Low-flow venovenous extracorporeal support with large-size membrane lung remains undefined. This study aimed to evaluate the VCO of a low-flow ECCO R with large-size membrane lung using a renal replacement therapy platform in an experimental animal model. Twelve healthy pigs were placed under mechanical ventilation and connected to an ECCO R-CRRT system (surface area = 1.8 m ; OMNIset®, BBraun, Germany). Respiratory settings were reduced to induce two degrees of hypercapnia. VCO was recorded under different combinations of PaCO (50-69 or 70-89 mm Hg), extracorporeal blood flow (ECBF; 200 or 350 mL/min), and gas flow (4, 6, or 10 L/min). VCO increased with ECBF at all three gas flow rates. In severe hypercapnia, the increase in sweep gas flow from 4 to 10 L/min increased VCO from 86.38 ± 7.08 to 96.50 ± 8.71 mL/min at an ECBF of 350 mL/min, whereas at ECBF of 200 mL/min, any increase was less effective. But in mild hypercapnia, the increase in sweep gas flow result in significantly increased VCO at two ECBF. VCO increased with PaCO from 50-69 to 70-89 mm Hg at an ECBF of 350 mL/min, but not at ECBF of 200 mL/min. Post-membrane lung PCO levels were similar for different levels of premembrane lung PCO (p = 0.08), highlighting the gas exchange diffusion efficacy of the membrane lung in gas exchange diffusion. In severe hypercapnia, the reduction of PaCO elevated from 11.5% to 19.6% with ECBF increase only at a high gas flow of 10 L/min (p