{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T19:03:09Z","timestamp":1774119789324,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2006,10,28]],"date-time":"2006-10-28T00:00:00Z","timestamp":1161993600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2006,10,28]],"date-time":"2006-10-28T00:00:00Z","timestamp":1161993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Extracorporeal lung assist, an extreme resource in patients with acute respiratory failure (ARF), is expanding its indications since knowledge about ventilator-induced lung injury has increased and protective ventilation has become the standard in ARF.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>A prospective study on seven adult sheep was conducted to quantify carbon dioxide (CO<jats:sub>2<\/jats:sub>) removal and evaluate the safety of an extracorporeal membrane gas exchanger placed in a veno-venous pump-driven bypass. Animals were anaesthetised, intubated, ventilated in order to reach hypercapnia, and then connected to the CO<jats:sub>2<\/jats:sub> removal device. Five animals were treated for three hours, one for nine hours, and one for 12 hours. At the end of the experiment, general anaesthesia was discontinued and animals were extubated. All of them survived.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>No significant haemodynamic variations occurred during the experiment. Maintaining an extracorporeal blood flow of 300 ml\/minute (4.5% to 5.3% of the mean cardiac output), a constant removal of arterial CO<jats:sub>2<\/jats:sub>, with an average reduction of 17% to 22%, was observed. Arterial partial pressure of carbon dioxide (PaCO<jats:sub>2<\/jats:sub>) returned to baseline after treatment discontinuation. No adverse events were observed.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>We obtained a significant reduction of PaCO<jats:sub>2<\/jats:sub> using low blood flow rates, if compared with other techniques. Percutaneous venous access, simplicity of circuit, minimal anticoagulation requirements, blood flow rate, and haemodynamic impact of this device are more similar to renal replacement therapy than to common extracorporeal respiratory assistance, making it feasible not only in just a few dedicated centres but in a large number of intensive care units as well.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc5082","type":"journal-article","created":{"date-parts":[[2006,10,28]],"date-time":"2006-10-28T18:14:20Z","timestamp":1162059260000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Efficacy and safety of a low-flow veno-venous carbon dioxide removal device: results of an experimental study in adult sheep"],"prefix":"10.1186","volume":"10","author":[{"given":"Sergio","family":"Livigni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariella","family":"Maio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrica","family":"Ferretti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Longobardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Potenza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Rivalta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Selvaggi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Vergano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Bertolini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2006,10,28]]},"reference":[{"key":"4603_CR1","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1152\/jappl.2000.89.4.1645","volume":"89","author":"CC Dos Santos","year":"2000","unstructured":"Dos Santos CC, Slutsky AS: Invited review: mechanisms of ventilator-induced lung injury: a perspective.\n                           J Appl Physiol 2000, 89: 1645-1655.","journal-title":"J Appl Physiol"},{"key":"4603_CR2","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1164\/rccm.200504-663OE","volume":"172","author":"GR Bernard","year":"2005","unstructured":"Bernard GR: Acute respiratory distress syndrome: a historical perspective.\n                           Am J Respir Crit Care Med 2005, 172: 798-806. 10.1164\/rccm.200504-663OE","journal-title":"Am J Respir Crit Care Med"},{"key":"4603_CR3","first-page":"793","volume":"49","author":"RH Kallet","year":"2004","unstructured":"Kallet RH: Evidence-based management of acute lung injury and acute respiratory distress syndrome.\n                           Respir Care 2004, 49: 793-809.","journal-title":"Respir Care"},{"key":"4603_CR4","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1007\/BF01735174","volume":"16","author":"KG Hickling","year":"1990","unstructured":"Hickling KG, Henderson SJ, Jackson R: Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome.\n                           Intensive Care Med 1990, 16: 372-377. 10.1007\/BF01735174","journal-title":"Intensive Care Med"},{"key":"4603_CR5","doi-asserted-by":"publisher","first-page":"R495","DOI":"10.1186\/cc2983","volume":"8","author":"BR Totapally","year":"2004","unstructured":"Totapally BR, Sussmane JB, Torbati D, Gelvez J, Fakioglu H, Mao Y, Olarte JL, Wolfsdorf J: Cardiovascular stability during arteriovenous extracorporeal therapy: a randomized controlled study in lambs with acute lung injury.\n                           Crit Care 2004, 8: R495-503. 10.1186\/cc2983","journal-title":"Crit Care"},{"key":"4603_CR6","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/00075198-200502000-00014","volume":"11","author":"F Mielck","year":"2005","unstructured":"Mielck F, Quintel M: Extracorporeal membrane oxygenation.\n                           Curr Opin Crit Care 2005, 11: 87-93. 10.1097\/00075198-200502000-00014","journal-title":"Curr Opin Crit Care"},{"key":"4603_CR7","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1001\/jama.1979.03300200023016","volume":"242","author":"WM Zapol","year":"1979","unstructured":"Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC 2nd, Thomas AN, Proctor HJ, et al.: Extracorporeal membrane oxygenation in severe acute respiratory failure. 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