None listed
Conditions
Brief summary
Some patients when receiving such mechanical ventilation develop hypercapnia and associated hypercapnic acidosis. Such patients have an increased risk of mortality. While the exact reasons of such increase in mortality is not known, it is recommended to minimise hypercapnia and hypercapnic acidosis during lung protective ventilation. Minimally invasive extracorporeal carbon dioxide removal (ECCO2R) devices are shown to reduce hypercapnia and hypercapnic acidosis. There are several devices that are currently available in the current clinical practice. However the effect of these devices on reduction in ventilator induced lung injury is not clearly demonstrated. This study aims to assess the reduction in ventilator induced lung injury with the use of ECCO2R device called Prismalung that is currently used in our intensive care unit. This assessment is done by measuring of pulmonary interleukins and blood interleukin levels as well as clinical assessment including the reduction of driving pressure.
Interventions
No specific exposure intervention that will be evaluated in this study. It investigates how effective is the intervention (ECCO2R with PrismaLung) that is being used on the patient in reducing the lung injury known to associated with mechanical ventilation.
This study includes patients already receiving ECCO2R with PrismaLung as part of their standard mechanical ventilation treatment,
Driving pressures on the ventilator prior to initiation of PrismaLung will be compared with the driving pressur
No specific exposure intervention that will be evaluated in this study. It investigates how effective is the intervention (ECCO2R with PrismaLung) that is being used on the patient in reducing the lung injury known to associated with mechanical ventilation. This study includes patients already receiving ECCO2R with PrismaLung as part of their standard mechanical ventilation treatment, Driving pressures on the ventilator prior to initiation of PrismaLung will be compared with the driving pressures while the patients are receiving PrismaLung for up to 144 hours. Arterial blood gasses and cytokine profile will be compared prior to initiation and after initiation of PrismaLung for up to 144 hours. All data will be available from the medical records.
Sponsors
Peninsula Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult patients (18 years or older) with diagnosis of ARDS as per the Berlin Definition.(Ref Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA. 2012; 307: 2526-33.) 2. Driving pressure ( P) > 14 and/or Plateau >/= 25 (P is calculated using as plateau pressure minus positive end-expiratory pressure). (Ref: Combes A, Auzinger G, Capellier G, et al. ECCO2R therapy in the ICU: consensus of a European round table meeting. Critical Care. 2020; 24: 490) 3. Respiratory rate > 20 breaths per minute 4. pH < 7.25 and PaCO2 >45
Exclusion criteria
1. ARDS lasting more than 72 hours at the time of inclusion 2. High pressure (Plateau pressure >30 cm H2O) or high FiO2 (>0·8) ventilation for more than 168 h (7 days); 3. Severe hemodynamic instability as defined by ongoing arrhythmias that is not responsive to treatment 4 Contraindication to limited anticoagulation 5. Treatment limitation including not for resuscitation and not for reintubation 6. Patients with potentially irreversible respiratory failure
Outcome results
None listed