Principles and Present Role of Extracorporal Elimination of CO₂ in the Therapy of Respiratory Failure

Abstract

Adult respiratory distress syndrome (ARDS), defined by Ashbaugh et al. [1] as an acute arterial hypoxia, has a high mortality. In the NIH study [8] in the early 1970s mortality was 80%–90%, and in the most recent European study by Artigas [3], for patients in Morel’s stages III–IV [7], the percentage is 70%. In this study we discuss ARDS patients in stages III and IV. Death, however, is not only caused by ARDS but also by the basic disease. The lungs of patients with severe progressive ARDS, i.e., with ARDS developing continuously for days or even weeks, show disturbances of ventilation and perfusion that are not only regionally distributed. They range from ventilated nonperfused to perfused nonventilated alveolar regions without fixed boundaries.