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Impact of membrane lung surface area and blood flow on extracorporeal CO2 removal during severe respiratory acidosis

Overview of attention for article published in Intensive Care Medicine Experimental, August 2017
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (62nd percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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6 tweeters
facebook
1 Facebook page

Citations

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44 Dimensions

Readers on

mendeley
44 Mendeley
Title
Impact of membrane lung surface area and blood flow on extracorporeal CO2 removal during severe respiratory acidosis
Published in
Intensive Care Medicine Experimental, August 2017
DOI 10.1186/s40635-017-0147-0
Pubmed ID
Authors

Christian Karagiannidis, Stephan Strassmann, Daniel Brodie, Philine Ritter, Anders Larsson, Ralf Borchardt, Wolfram Windisch

Abstract

Veno-venous extracorporeal CO2 removal (vv-ECCO2R) is increasingly being used in the setting of acute respiratory failure. Blood flow rates through the device range from 200 ml/min to more than 1500 ml/min, and the membrane surface areas range from 0.35 to 1.3 m(2). The present study in an animal model with similar CO2 production as an adult patient was aimed at determining the optimal membrane lung surface area and technical requirements for successful vv-ECCO2R. Four different membrane lungs, with varying lung surface areas of 0.4, 0.8, 1.0, and 1.3m(2) were used to perform vv-ECCO2R in seven anesthetized, mechanically ventilated, pigs with experimentally induced severe respiratory acidosis (pH 7.0-7.1) using a 20Fr double-lumen catheter with a sweep gas flow rate of 8 L/min. During each experiment, the blood flow was increased stepwise from 250 to 1000 ml/min. Amelioration of severe respiratory acidosis was only feasible when blood flow rates from 750 to 1000 ml/min were used with a membrane lung surface area of at least 0.8 m(2). Maximal CO2 elimination was 150.8 ml/min, with pH increasing from 7.01 to 7.30 (blood flow 1000 ml/min; membrane lung 1.3 m(2)). The membrane lung with a surface of 0.4 m(2) allowed a maximum CO2 elimination rate of 71.7 mL/min, which did not result in the normalization of pH, even with a blood flow rate of 1000 ml/min. Also of note, an increase of the surface area above 1.0 m(2) did not result in substantially higher CO2 elimination rates. The pressure drop across the oxygenator was considerably lower (<10 mmHg) in the largest membrane lung, whereas the smallest revealed a pressure drop of more than 50 mmHg with 1000 ml blood flow/min. In this porcine model, vv-ECCO2R was most effective when using blood flow rates ranging between 750 and 1000 ml/min, with a membrane lung surface of at least 0.8 m(2). In contrast, low blood flow rates (250-500 ml/min) were not sufficient to completely correct severe respiratory acidosis, irrespective of the surface area of the membrane lung being used. The converse was also true, low surface membrane lungs (0.4 m(2)) were not capable of completely correcting severe respiratory acidosis across the range of blood flows used in this study.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 44 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 23%
Student > Ph. D. Student 6 14%
Other 4 9%
Student > Bachelor 4 9%
Student > Master 3 7%
Other 7 16%
Unknown 10 23%
Readers by discipline Count As %
Medicine and Dentistry 22 50%
Engineering 2 5%
Nursing and Health Professions 2 5%
Chemical Engineering 1 2%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 2 5%
Unknown 14 32%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 September 2017.
All research outputs
#3,758,670
of 12,818,197 outputs
Outputs from Intensive Care Medicine Experimental
#62
of 234 outputs
Outputs of similar age
#93,783
of 264,119 outputs
Outputs of similar age from Intensive Care Medicine Experimental
#7
of 10 outputs
Altmetric has tracked 12,818,197 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 234 research outputs from this source. They receive a mean Attention Score of 3.2. This one has gotten more attention than average, scoring higher than 70% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,119 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 62% of its contemporaries.
We're also able to compare this research output to 10 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.