EXTRACORPOREAL CARBON-DIOXIDE REMOVAL AND LOW-FREQUENCY POSITIVE-PRESSURE VENTILATION - IMPROVEMENT IN ARTERIAL OXYGENATION WITH REDUCTION OF RISK OF PULMONARY BAROTRAUMA IN PATIENTS WITH ADULT-RESPIRATORY-DISTRESS-SYNDROME

Mortality of the adult respiratory distress syndrome (ARDS) remains hi gh and could be increased by pulmonary barotrauma induced by positive- pressure mechanical ventilation. Extracorporeal CO2 removal combined w ith low-frequency positive-pressure ventilation (ECCO2R-LFPPV) has bee n proposed to reduce lung injury while supporting respiratory failure. Use of this technique in 23 patients resulted in the following: a dra matic and highly significant increase of PaO2 obtained rapidly with EC CO2R-LFPPV, allowing subsequent reduction in inspired oxygen fraction; a reduction of the risk of barotrauma evidenced by a significant decr ease in pressures and insufflated volumes; a survival rate of 50 perce nt. Bleeding was the only complication related to the technique and wa s the cause of death in four patients. This method allowed improvement in ps exchange along with reduction of the risk of barotrauma caused by the ventilator.