IVOX in ARDS: respiratory effects and serious complications

Abstract

I IV VO OX X i in n A AR RD DS S: : r re es sp pi ir ra at to or ry y e ef ff fe ec ct ts s a an nd d s se er ri io ou us s c co om mp pl li ic ca at ti io on ns s IVOX in ARDS: respiratory effects and serious complications. Y. Gasche, J.A. Romand, R. Prêtre, P.M. Suter. ERS Journals Ltd 1994. ABSTRACT: We describe the beneficial effects of an intravenous oxygenator (IVOX) on ventilatory pressure requirement, and also several severe complications related to its use in a young trauma victim developing severe acute respiratory distress syndrome (ARDS).In this patient, adequate systemic oxygenation could not be maintained despite the use of fractional inspired oxygen of 1.0, high level positive end-expiratory pressure (PEEP), and nitric oxide inhalation (30 ppm). The introduction of an intravenous oxygenator improved arterial oxygenation and CO 2 elimination, allowing a decrease in minute ventilation and airway pressure. However, hepatic cytolysis, acute renal dysfunction and iliac vein thrombosis developed concomitantly, in spite of full anticoagulation with heparin. These complications resolved rapidly after removal of the IVOX device and the patient made a good recovery.

Improved Arterial Blood Oxygenation following Intravenous Infusion of Cold Supersaturated Dissolved Oxygen Solution

“…For more than two centuries, researchers have evaluated methods to augment gas exchange via the intravenous (IV) route and improve oxygenation during treatment of severe cardiopulmonary disease 1–5. One such method attempted has been the IV injection of gaseous oxygen 6,7.…”

“…For more than two centuries, researchers have evaluated methods to augment gas exchange via the intravenous (IV) route and improve oxygenation during treatment of severe cardiopulmonary disease. 15 One such method attempted has been the IV injection of gaseous oxygen. 6,7 However, subsequent research into the direct IV injection of gaseous oxygen found the technique to be extremely hazardous and frequently fatal due to the formation of large gaseous emboli.…”

Lung replacement therapies for acute respiratory failure

“…(18) The IVOX is surgically deployed into the inferior or superior vena cava via a femoral or jugular venotomy, by which gas exchange occurs through the hollow fibers driven by a vacuum pump. (19) There is no extracorporeal circulation of blood. Gas exchange is accomplished as the patient's blood flows through the hollow fibers via inlet and outlet gas conduits for oxygen infusion and CO2 elimination.…”