Vergleich Extrakorporaler high-flow und low-flow Lungenersatzverfahren im Großtier-ARDS-Modell

by Jona Wassong
Doctoral thesis
Date of Examination:2025-09-16
Date of issue:2025-08-11
Advisor:Prof. Dr. Onnen Mörer
Referee:PD Dr. Martin Friedrich
Referee:PD Dr. Torben Lange
Persistent Address: http://dx.doi.org/10.53846/goediss-11434

 

 

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Abstract

English

Acute Respiratory Distress Syndrome (ARDS) is a complex critical care condition requiring lung-protective ventilation strategies to minimize ventilator-induced lung injury (VILI). Extracorporeal support systems such as ECMO and ECCO₂R are often used to facilitate ultra-protective ventilation. This study aimed to compare the effectiveness of high-flow ECMO and low-flow ECCO₂R regarding gas exchange in a large animal ARDS model. Twenty-four animals were assigned to two different ARDS models (saline aspiration vs. oleic acid infusion) and treated with either ECMO or ECCO₂R. While both interventions achieved similar arterial oxygenation, ECMO resulted in better systemic oxygen delivery, improved hemodynamics, and reduced oxygen consumption and CO₂ production. In contrast, ECCO₂R was associated with impaired hemodynamics and increased respiratory workload. The findings suggest that ECMO is the more effective strategy in severe ARDS, whereas ECCO₂R may be considered a less invasive alternative in moderate cases.
Keywords: ARDS; Extracorporeal circulation; Extracorporeal membrane oxygenation; Extracorporeal carbon dioxide removal
 
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