Peer-Reviewed Journal Details
Mandatory Fields
Combes, A;Fanelli, V;Pham, T;Ranieri, VM;Goligher, EC;Brodie, D;Pesenti, A;Beale, R;Brochard, L;Chiche, JD;Fan, E;de Backer, D;Francois, G;Ferguson, N;Laffey, J;Mercat, A;McAuley, DF;Muller, T;Quintel, M;Vincent, JL;Taccone, FS;Peperstraete, H;Morimont, P;Schmidt, M;Levy, B;Diehl, JL;Guervilly, C;Capelier, G;Vieillard-Baron, A;Messika, J;Karagiannidis, C;Moerer, O;Urbino, R;Antonelli, M;Mojoli, F;Alessandri, F;Grasselli, G;Donker, D;Ferrer, R;Mancebo, J;Slutsky, AS
2019
May
Intensive Care Medicine
Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study
Published
Altmetric: 207WOS: 1 ()
Optional Fields
LUNG INJURY 6 ML/KG HYPERCAPNIA PRESSURE ECCO2R
45
592
600
PurposeWe assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (V-T 4mL/kg and P(PLAT)25cmH(2)O) in patients with moderate acute respiratory distress syndrome (ARDS).MethodsProspective multicenter international phase 2 study. Primary endpoint was the proportion of patients achieving ultra-protective ventilation with PaCO2 not increasing more than 20% from baseline, and arterial pH>7.30. Severe adverse events (SAE) and ECCO2R-related adverse events (ECCO2R-AE) were reported to an independent data and safety monitoring board. We used lower CO2 extraction and higher CO2 extraction devices (membrane lung cross-sectional area 0.59 vs. 1.30m(2); flow 300-500mL/min vs. 800-1000mL/min, respectively).ResultsNinety-five patients were enrolled. The proportion of patients who achieved ultra-protective settings by 8h and 24h was 78% (74 out of 95 patients; 95% confidence interval 68-89%) and 82% (78 out of 95 patients; 95% confidence interval 76-88%), respectively. ECCO2R was maintained for 5 [3-8]days. Six SAEs were reported; two of them were attributed to ECCO2R (brain hemorrhage and pneumothorax). ECCO2R-AEs were reported in 39% of the patients. A total of 69 patients (73%) were alive at day 28. Fifty-nine patients (62%) were alive at hospital discharge.ConclusionsUse of ECCO2R to facilitate ultra-protective ventilation was feasible. A randomized clinical trial is required to assess the overall benefits and harms.Clinicaltrials.govNCT02282657
0342-4642
10.1007/s00134-019-05567-4
Grant Details
Publication Themes