Evidence map›Paper›PMID 41254306›Full record

ArticleIntensive care medicine experimental2025

Effect of low bicarbonate substitution solution on CO

Zhicheng Qian, Rui Zhang, Yuxuan Wang, Hao He, Shike Geng, Yang Li, Xueyan Yuan, Yi Yang, Haibo Qiu, Songqiao Liu and 1 more

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In one paragraph

Article in Intensive care medicine experimental, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Zhicheng Qian *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Rui Zhang *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Yuxuan WangJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Hao HeJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Shike GengJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Yang LiJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Xueyan YuanJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Yi YangJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Haibo QiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Songqiao LiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Ling LiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China. liulingdoctor@126.com.

Funding

Jiangsu Provincial Medical Key Laboratory LGY2022025Jilin Provincial Key Research and Development Plan Project BF2024054National Key R&D Program of China 2024ZD0530000，2022YFC2504405the National Natural Science Foundation of China 82270083the National Natural Science Foundation of China 82470079the Second Level Talents of the "333 High Level Talents Training Project"in the sixth phase in Jiangsu LGY2022025
6 · The paper itself

Abstract

backgroundThe concurrent application of extracorporeal carbon dioxide removal (ECCO₂R) and continuous renal replacement therapy (CRRT) delivers essential respiratory and renal support. However, the use of bicarbonate (HCO₃⁻) in substitution solution increases the external HCO₃⁻ load and affect the carbon dioxide removal rate (VCO₂). This study aims to investigate the influence of low bicarbonate substitution solution on VCO₂ within the combined ECCO₂R-CRRT system.

methodsThis 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 mL/min) alongside three continuous veno-venous hemofiltration (CVVH) strategies: a control group receiving ECCO₂R alone without CVVH, a low HCO₃⁻ group receiving ECCO₂R combined with CVVH (HCO₃⁻ concentration of 16 mmol/L at a substitution rate of 30 mL/kg/h), and a normal HCO₃⁻ group (HCO₃⁻ concentration of 25 mmol/L). Respiratory variables, hemodynamic parameters, and VCO₂ were measured 30 min after each intervention. In ARDS patients, we also assessed ECCO₂R combined with these CVVH strategies. The primary endpoint was the comparison of VCO₂ among the three groups in both the pig and patient.

resultsThis study involved 12 hypercapnic pigs. At a blood flow rate of 200 mL/min, the VCO

conclusionA low bicarbonate concentration of 16 mmol/L in the substitution solution may optimize CO₂ elimination in the ECCO₂R-CRRT system, especially at lower extracorporeal blood flow rates.

Indexed as

Carbon dioxide removal rateContinuous veno-venous hemofiltrationExtracorporeal carbon dioxide removalHypercapniaLow bicarbonate substitution solution

Identifiers

PMID41254306
PMCPMC12627315

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.