Liquid extracorporeal carbon dioxide removal: use of THAM (tris-hydroxymethyl aminomethane) coupled to hemofiltration to control hypercapnic acidosis in a porcine model of protective mechanical ventilation

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dc.contributor.authorTapia, Pablo
dc.contributor.authorLillo, Felipe
dc.contributor.authorSoto, Dagoberto
dc.contributor.authorEscobar, Leslie
dc.contributor.authorSimon, Felipe
dc.contributor.authorHernandez, Karina
dc.contributor.authorAlegria, Leyla
dc.contributor.authorBruhn, Alejandro
dc.date.accessioned2025-01-23T21:28:22Z
dc.date.available2025-01-23T21:28:22Z
dc.date.issued2016
dc.description.abstractA promising approach to facilitate protective mechanical ventilation is the use of extracorporeal CO2 removal techniques. Several strategies based on membrane gas exchangers have been developed. However, these techniques are still poorly available. The goal of this study was to assess the efficacy and safety of THAM infusion coupled to hemofiltration for the management of hypercapnic acidosis. A severe respiratory acidosis was induced in seven anesthetized pigs. Five of them were treated with THAM 8-mmol . kg(-1) . h(-1) coupled to hemofiltration (THAM+HF group) at 100 mL . kg(-1) . h(-1). After 18-hours of treatment the THAM infusion was stopped but hemofiltration was kept on until 24-hours. The 2 other animals were treated with THAM but without hemofiltration. After 1-hour of treatment in THAM+HF, PaCO2 rapidly decreased from a median of 89.0 (IQR) (80.0, 98.0) to 71.3 (65.8, 82.0) mmHg (P<0.05), while pH increased from 7.12 (7.01, 7.15) to 7.29 (7.27, 7.30) (P<0.05). Thereafter PaCO2 remained stable between 60-70 mmHg, while pH increased above 7.4. After stopping THAM at 18 hours of treatment a profound rebound effect was observed with severe hypercapnic acidosis. The most important side effect we observed was hyperosmolality, which reached a maximum of 330 (328, 332) mOsm . kg H2O-1 at T18. The animals treated only with THAM developed severe hypercapnia, despite the fact that pH returned to normal values, and died after 12 hours. Control-group had an uneven evolution until the end of the experiment. A combined treatment with THAM coupled to hemofiltration may be an effective treatment to control severe hypercapnic acidosis.
dc.fuente.origenWOS
dc.identifier.issn1943-8141
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/101406
dc.identifier.wosidWOS:000383548000019
dc.issue.numero8
dc.language.isoen
dc.pagina.final3502
dc.pagina.inicio3493
dc.revistaAmerican journal of translational research
dc.rightsacceso restringido
dc.subjectAcute respiratory distress syndrome
dc.subjectextracorporeal CO2 removal
dc.subjecthemofiltration
dc.subjecthypercapnia
dc.subjectTris hydroxymethyl aminomethane (THAM)
dc.subjectventilator induced lung injury
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLiquid extracorporeal carbon dioxide removal: use of THAM (tris-hydroxymethyl aminomethane) coupled to hemofiltration to control hypercapnic acidosis in a porcine model of protective mechanical ventilation
dc.typeartículo
dc.volumen8
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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