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Low-Frequency Positive Pressure Ventilation with Extracorporeal Carbon Dioxide Removal (LFPPV-ECCO₂R)

An Experimental Study

L. GATTINONI, MD^*,||, T. KOLOBOW, MD^,||, T. TOMLINSON, BS^,||, G. IAPICHINO, MD^*,||, M. SAMAJA, PhD^,||, D. WHITE, MD^,||, and J. PIERCE, DVM^,||

*Assistant Professor in Anesthesia. Present address: Institute of Anesthesiology, University of Milan, Via F. Sforza 35, 20122, Milano, Italy Senior Investigator Biologist Staff Associate ||National Institutes of Health, National Heart, Lung. and Blood Institute, Laboratory of Technical Development, Building 10, Room 5D-20, Bethesda, Maryland 20014

Abstract

We describe a new form of mechanical pulmonary ventilation, low-frequency positive pressure ventilation with extracorporeal CO₂ removal (LFPPV-ECCO₂R). In a series of animal studies the rate of mechanical ventilation was 0.66, 1, 2, and 4 min^–1 at a tidal volume of 3, 10, and 15 ml kg^–]. We were able to maintain normal blood gases and normal lung volumes and lung mechanics even at the lowest ventilator rate with tidal volumes of 10 or 15 ml kg^–1. Each experiment lasted 7 hours. Our data suggest a possible new dimension in the management of a difficult patient on mechanical pulmonary ventilation.

Key Words: VENTILATION, extracorporeal CO₂ removal and

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