Novel CO 2 removal device driven by a renal-replacement system without hemofilter. A first step experimental validation

Objectives: To study the technical effectiveness of a novel extracorporeal CO2 removal device in removing CO2 from blood. Study design: Prospective animal study. Animals: Five adult female healthy pigs. Methods: Hypercapnic pigs were equipped with a low-flow CO2 removal device (PrismaLung (R), Hospal (R)) integrated on a CRRT platform. The rate of CO2 elimination was examined in vivo using a hollow fiber gas exchanger under various conditions (blood flow rates: 200, 300 and 400 mL/min; sweep gas flows: 2, 5, 10 and 50 L/min; FsO(2): 0.21 and 1). Statistical analysis was performed with Student t-test. Results: The extracorporeal device produced CO2 removal rates ranging from 35 to 75 mL/min. Efficiency was increased with higher blood and sweep gas flows: reduction of PCO2 of 40.2 +/- 13.0 mmHg (relative decrease of 46%, P < 0.001) and increase in pH of 0.24 +/- 0.06 (7.21 before and 7.46 after filter, P < 0.001). Animals' blood gases were significantly modified after 10 minutes of treatment: PaCO2 decreased from 81.2 to 70.0 mmHg (relative decrease of 14%, P < 0.001) and pH increased from 7.17 to 7.22 (P < 0.001). No significant changes in arterial blood oxygenation were observed when using pure oxygen (increase of PaO2 from 106 to 107 mmHg, P = 0.36), allowing the use of ambient air as sweep gas through the membrane. Conclusions: A device based on a Prismaflex (R) platform was technically effective in removing CO2 from the blood, thus decreasing PaCO2 and acidosis in hypercapnic pigs. (C) 2015 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.