Abstract
We report about our first experiences with a new device for continuous intra-arterial monitoring of blood gases in a patient with severe acute respiratory failure. This device facilitated continuous monitoring of PaO2, PaCO2 and pH while weaning the patient from extracorporeal membrane oxygenation (ECMO). Although sufficient oxygenation at FIO2 0.45 could be achieved after disconnection from ECMO, carbon dioxide elimination remained inadequate and resulted in severe respiratory acidosis. Within six hours, PaCO2 increased to 95 mmHg. Continuous monitoring of pH and PaCO2 helped to monitor CO2 retention and assisted the decision making process for reinstitution of ECMO.
References
Hickling KG, Henderson SJ, Jackson R (1990) Low mortality associated with low volume pressure limited ventication with permissive hypercapnia in severe adult respiratory districs syndrome. Intensive Care Med 16:372–377
Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome [published erratum appears in Am Rev Respir Dis 1989 Apr; 139(4):1065]. Am Rev Respir Dis 138:720–723
Rossaint R, Pappert D, Lewandowski K, Slama K, Falke K (1992) A new therapeutic stragedy to reduce the mortality in severe ARDS. Med Care Int 7–8:31–35
Baum M, Benzer H, Putensen Ch, Koller W, Putz G (1989) Biphasic positive airway pressure (BIPAP) — eine neue Form der augmentierten Beatmung. Anaesthesist 38:452–458
Kolobow T, Moretti MP, Fumagalli R, Mascheroni D, Prato P, Chen V, Joris M (1987) Severe impairement in lung function induced by high peak airway pressure during mechanical ventilation. Am Rev Respir Dis 135:312–315
Dreyfuss D, Basset G, Soler P, Saumon G (1985) Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Am Rev Respir Dis 132:880–884
Lewandowski K, Rossaint R, Slama K, Gerlach H, Pappert D, Kuhlen R, Falke KJ (1992) Aktueller Stand der Behandlung des schweren ARDS einschließlich der Verwendung des extrakorporalen Gasaustauschs. Z Herz-, Thorax- Gefäßchir 6:300–305
Bagent RA (1975) Variations in arterial blood gas measurements due to sampling techniques. Respir Care 20:565–570
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Pappert, D., Rossaint, R., Gerlach, H. et al. Continuous monitoring of blood gases during hypercapnia in a patient with severe acute lung failure. Intensive Care Med 20, 210–211 (1994). https://doi.org/10.1007/BF01704702
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DOI: https://doi.org/10.1007/BF01704702