{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:21:20Z","timestamp":1779366080243,"version":"3.53.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"crossref","award":["2024ZD0530000\uff0c2022YFC2504405"],"award-info":[{"award-number":["2024ZD0530000\uff0c2022YFC2504405"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013141","name":"Jilin Provincial Key Research and Development Plan Project","doi-asserted-by":"publisher","award":["BF2024054"],"award-info":[{"award-number":["BF2024054"]}],"id":[{"id":"10.13039\/501100013141","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82470079"],"award-info":[{"award-number":["82470079"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82270083"],"award-info":[{"award-number":["82270083"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Second Level Talents of the \u201c333 High Level Talents Training Project\u201din the sixth phase in Jiangsu","award":["LGY2022025"],"award-info":[{"award-number":["LGY2022025"]}]},{"name":"Jiangsu Provincial Medical Key Laboratory","award":["LGY2022025"],"award-info":[{"award-number":["LGY2022025"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["ICMx"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The concurrent application of extracorporeal carbon dioxide removal (ECCO\u2082R) and continuous renal replacement therapy (CRRT) delivers essential respiratory and renal support. However, the use of bicarbonate (HCO\u2083\u207b) in substitution solution increases the external HCO\u2083\u207b load and affect the carbon dioxide removal rate (VCO\u2082). This study aims to investigate the influence of low bicarbonate substitution solution on VCO\u2082 within the combined ECCO\u2082R-CRRT system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This crossover study was conducted with hypercapnic pigs and patients with acute respiratory distress syndrome (ARDS). In pigs, we tested two extracorporeal blood flow rates (200 and 350\u00a0mL\/min) alongside three continuous veno-venous hemofiltration (CVVH) strategies: a control group receiving ECCO\u2082R alone without CVVH, a low HCO\u2083\u207b group receiving ECCO\u2082R combined with CVVH (HCO\u2083\u207b concentration of 16\u00a0mmol\/L at a substitution rate of 30\u00a0mL\/kg\/h), and a normal HCO\u2083\u207b group (HCO\u2083\u207b concentration of 25\u00a0mmol\/L). Respiratory variables, hemodynamic parameters, and VCO\u2082 were measured 30\u00a0min after each intervention. In ARDS patients, we also assessed ECCO\u2082R combined with these CVVH strategies. The primary endpoint was the comparison of VCO\u2082 among the three groups in both the pig and patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study involved 12 hypercapnic pigs. At a blood flow rate of 200\u00a0mL\/min, the VCO\n                      <jats:sub>2<\/jats:sub>\n                      were significantly different among groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.029). The VCO\u2082 in the low HCO\u2083\u207b group (51.7\u2009\u00b1\u20096.0\u00a0mL\/min) was significantly higher than that in the normal HCO\u2083\u207b group (46.1\u2009\u00b1\u20092.9\u00a0mL\/min) and comparable to the control group (50.3\u2009\u00b1\u20095.4\u00a0mL\/min). However, at a blood flow rate of 350\u00a0mL\/min, VCO\u2082 values were similar across all three groups. In 10 ARDS patients with a mean age of 64\u2009\u00b1\u20098\u00a0years, the PaCO\u2082 was 60.0\u2009\u00b1\u20094.7\u00a0mmHg prior to ECCO\u2082R. At a blood flow rate of 293\u2009\u00b1\u200959\u00a0mL\/min, VCO\u2082 did not change significantly in the low HCO\u2083\u207b group (77.0\u2009\u00b1\u200916.2\u00a0mL\/min) compared to the control group (75.2\u2009\u00b1\u200915.9\u00a0mL\/min), a decrease was noted in the normal HCO\u2083\u207b group (69.9\u2009\u00b1\u200916.6\u00a0mL\/min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A low bicarbonate concentration of 16\u00a0mmol\/L in the substitution solution may optimize CO\u2082 elimination in the ECCO\u2082R\u2013CRRT system, especially at lower extracorporeal blood flow rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40635-025-00827-8","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T02:38:04Z","timestamp":1763519884000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of low bicarbonate substitution solution on CO2 removal rate in the combined system of extracorporeal CO2 removal and continuous renal replacement therapy"],"prefix":"10.1186","volume":"13","author":[{"given":"Zhicheng","family":"Qian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shike","family":"Geng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songqiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"issue":"4","key":"827_CR1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1164\/rccm.201710-2130CP","volume":"198","author":"SA Conrad","year":"2018","unstructured":"Conrad SA, Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Di Nardo M, Belliato M, Grazioli L, Barbaro RP, McMullan DM, Pellegrino V, Brodie D, Bembea MM, Fan E, Mendonca M, Diaz R, Bartlett RH (2018) The extracorporeal life support organization Maastricht treaty for nomenclature in extracorporeal life support. 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