Treatment of Refractory Intraoperative Hypoxemia After Trauma With Venovenous Extracorporeal Membrane Oxygenation: A Case Report.

Extracorporeal membrane oxygenation has emerged as a treatment of choice for refractory hypoxemia in the intensive care unit. Severe hypoxemia unresponsive to conventional lung-protective mechanical ventilation could also occur in the operating room from severe bronchospasm, pulmonary contusions, or acute respiratory distress syndrome. We report a case of acute hypoxic respiratory failure in an adolescent with blunt chest trauma that was successfully managed with the intraoperative initiation of venovenous extracorporeal membrane oxygenation during the initial damage control surgery.

Experimental and computational studies of binding of dinitrogen, nitriles, azides, diazoalkanes, pyridine, and pyrazines to M(PR(3))(2)(CO)(3) (M = Mo, W; R = Me, (i)Pr).

The enthalpies of binding of a number of N-donor ligands to the complex Mo(P(i)Pr(3))(2)(CO)(3) in toluene have been determined by solution calorimetry and equilibrium measurements. The measured binding enthalpies span a range of approximately 10 kcal mol(-1): DeltaH(binding) = -8.8 +/- 1.2 (N(2)-Mo(P(i)Pr(3))(2)(CO)(3)); -10.3 +/- 0.8 (N(2)); -11.2 +/- 0.4 (AdN(3) (Ad = 1-adamantyl)); -13.8 +/- 0.5 (N(2)CHSiMe(3)); -14.9 +/- 0.9 (pyrazine = pz); -14.8 +/- 0.6 (2,6-Me(2)pz); -15.5 +/- 1.8 (Me(2)NCN); -16.6 +/- 0.4 (CH(3)CN); -17.0 +/- 0.4 (pyridine); -17.5 +/- 0.8 ([4-CH(3)pz][PF(6)] (in tetrahydrofuran)); -17.6 +/- 0.4 (C(6)H(5)CN); -18.6 +/- 1.8 (N(2)CHC( horizontal lineO)OEt); and -19.3 +/- 2.5 kcal mol(-1) (pz)Mo(P(i)Pr(3))(2)(CO)(3)). The value for the isonitrile AdNC (-29.0 +/- 0.3) is 12.3 kcal mol(-1) more exothermic than that of the nitrile AdCN (-16.7 +/- 0.6 kcal mol(-1)). The enthalpies of binding of a range of arene nitrile ligands were also studied, and remarkably, most nitrile complexes were clustered within a 1 kcal mol(-1) range despite dramatic color changes and variation of nu(CN). Computed structural and spectroscopic parameters for the complexes Mo(P(i)Pr(3))(2)(CO)(3)L are in good agreement with experimental data. Computed binding enthalpies for Mo(P(i)Pr(3))(2)(CO)(3)L exhibit considerable scatter and are generally smaller compared to the experimental values, but relative agreement is reasonable. Computed enthalpies of binding using a larger basis set for Mo(PMe(3))(2)(CO)(3)L show a better fit to experimental data than that for Mo(P(i)Pr(3))(2)(CO)(3)L using a smaller basis set. Crystal structures of Mo(P(i)Pr(3))(2)(CO)(3)(AdCN), W(P(i)Pr(3))(2)(CO)(3)(Me(2)NCN), W(P(i)Pr(3))(2)(CO)(3)(2,6-F(2)C(6)H(3)CN), W(P(i)Pr(3))(2)(CO)(3)(2,4,6-Me(3)C(6)H(2)CN), W(P(i)Pr(3))(2)(CO)(3)(2,6-Me(2)pz), W(P(i)Pr(3))(2)(CO)(3)(AdCN), Mo(P(i)Pr(3))(2)(CO)(3)(AdNC), and W(P(i)Pr(3))(2)(CO)(3)(AdNC) are reported.

Synthesis, structure, and thermochemistry of the formation of the metal-metal bonded dimers [Mo(mu-TeAr)(CO)3(PiP3)]2 (Ar = phenyl, naphthyl) by phosphine elimination from *Mo(TePh)(CO)3(PiPr3)2.

The complexes (*TeAr)Mo(CO)3(PiPr3)2 (Ar = phenyl, naphthyl; iPr = isopropyl) slowly eliminate PiPr3 at room temperature in a toluene solution to quantitatively form the dinuclear complexes [Mo(mu-TeAr)(CO)3(PiPr3)]2. The crystal structure of [Mo(mu-Te-naphthyl)(CO)3(PiPr3)]2 is reported and has a Mo-Mo distance of 3.2130 A. The enthalpy of dimerization has been measured and is used to estimate a Mo-Mo bond strength on the order of 30 kcal mol-1. Kinetic studies show the rate of formation of the dimeric chalcogen bridged complex is best fit by a rate law first order in (*TeAr)Mo(CO)3(PiPr3)2 and inhibited by added PiPr3. The reaction is proposed to occur by initial dissociation of a phosphine ligand and not by radical recombination of 2 mol of (*TeAr)Mo(CO)3(PiPr3)2. Reaction of (*TePh)Mo(CO)3(PiPr3)2, with L = pyridine (py) or CO, is rapid and quantitative at room temperature to form PhTeTePh and Mo(L)(CO)3(PiPr3)2, in keeping with thermochemical predictions. The rate of reaction of (*TeAr)W(CO)3(PiPr3)2 and CO is first-order in the metal complex and is proposed to proceed by the associative formation of the 19 e- radical complex (*TePh)W(CO)4(PiPr3)2 which extrudes a *TePh radical.

Comparison of thermodynamic and kinetic aspects of oxidative addition of PhE-EPh (E = S, Se, Te) to Mo(CO)3(PR3)2, W(CO)3(PR3)2, and Mo(N[tBu]Ar)3 complexes. The role of oxidation state and ancillary ligands in metal complex induced chalcogenyl radical generation.

Enthalpies of oxidative addition of PhE-EPh (E = S, Se, Te) to the M(0) complexes M(PiPr3)2(CO)3 (M = Mo, W) to form stable complexes M(*EPh)(PiPr3)2(CO)3 are reported and compared to analogous data for addition to the Mo(III) complexes Mo(N[tBu]Ar)3 (Ar = 3,5-C6H3Me2) to form diamagnetic Mo(IV) phenyl chalcogenide complexes Mo(N[tBu]Ar)3(EPh). Reactions are increasingly exothermic based on metal complex, Mo(PiPr3)2(CO)3 < W(PiPr3)2(CO)3 < Mo(N[tBu]Ar)3, and in terms of chalcogenide, PhTe-TePh < PhSe-SePh < PhS-SPh. These data are used to calculate LnM-EPh bond strengths, which are used to estimate the energetics of production of a free *EPh radical when a dichalcogenide interacts with a specific metal complex. To test these data, reactions of Mo(N[tBu]Ar)3 and Mo(PiPr3)2(CO)3 with PhSe-SePh were studied by stopped-flow kinetics. First- and second-order dependence on metal ion concentration was determined for these two complexes, respectively, in keeping with predictions based on thermochemical data. ESR data are reported for the full set of bound chalcogenyl radical complexes (PhE*)M(PiPr3)2(CO)3; g values increase on going from S to Se, to Te, and from Mo to W. Calculations of electron densities of the SOMO show increasing electron density on the chalcogen atom on going from S to Se to Te. The crystal structure of W(*TePh)(PiPr3)2(CO)3 is reported.

Solution calorimetric and stopped-flow kinetic studies of the reaction of *Cr(CO)3C5Me5 with PhSe-SePh and PhTe-TePh. Experimental and theoretical estimates of the Se-Se, Te-Te, H-Se, and H-Te bond strengths.

The kinetics of the oxidative addition of PhSeSePh and PhTeTePh to the stable 17-electron complex *Cr(CO)3C5Me5 have been studied utilizing stopped-flow techniques. The rates of reaction are first-order in each reactant, and the enthalpy of activation decreases in going from Se (deltaH(double dagger) = 7.0 +/- 0.5 kcal/mol, deltaS(double dagger) = -22 +/- 3 eu) to Te (deltaH(double dagger) = 4.0 +/- 0.5 kcal/mol, deltaS(double dagger) = -26 +/- 3 eu). The kinetics of the oxidative addition of PhSeH and *Cr(CO)3C5Me5 show a change in mechanism in going from low (overall third-order) to high (overall second-order) temperatures. The enthalpies of the oxidative addition of PhE-EPh to *Cr(CO)3C5Me5 in toluene solution have been measured and found to be -29.6, -30.8, and -28.9 kcal/mol for S, Se, and Te, respectively. These data are combined with enthalpies of activation from kinetic studies to yield estimates for the solution-phase PhE-EPh bond strengths of 46, 41, and 33 kcal/mol for E = S, Se, and Te, respectively. The corresponding Cr-EPh bond strengths are 38, 36, and 31 kcal/mol. Two methods have been used to determine the enthalpy of hydrogenation of PhSeSePh in toluene on the basis of reactions of HSPh and HSePh with either *Cr(CO)3C5Me5 or 2-pyridine thione. These data lead to a thermochemical estimate of 72 kcal/mol for the PhSe-H bond strength in toluene solution, which is in good agreement with kinetic studies of H atom transfer from HSePh at higher temperatures. The reaction of H-Cr(CO)3C5Me5 with PhSe-SePh is accelerated by the addition of a Cr radical and occurs via a rapid radical chain reaction. In contrast, the reaction of PhTe-TePh and H-Cr(CO)3C5Me5 does not occur at any appreciable rate at room temperature, even in the presence of added Cr radicals. This is in keeping with a low PhTe-H bond strength blocking the chain and implies that H-TePh < or = 63 kcal/mol. Structural data are reported for PhSe-Cr(CO)3C5Me5 and PhS-Cr(CO)3C5Me5. The two isostructural complexes do not show signs of an increase in steric strain in terms of metal-ligand bonds or angles as the Cr-EPh bond is shortened in going from Se to S. Bond strength estimates of the PhE-H and PhE-EPh derived from density functional theory calculations are in reasonable agreement with experimental data for E = Se but not for E = Te. The nature of the singly occupied molecular orbital of the *EPh radicals is calculated to show increasing localization on the chalcogenide atom in going from S to Se to Te.