Extracorporeal carbondioxide removal (ECCO2R): case series and review of literature.

Background: Ventilation treatment has proven success in acute respiratory distress syndrome (ARDS), while it still remains a challenge to utilize it with lower tidal volumes especially in subjects with respiratory acidosis. The concept of supporting conventional ventilation with extracorporeal carbondioxide removal (ECCO2R) may contribute in adjusting respiratory acidosis consequent to tidal volume reduction in protective ventilation setting. This method allows an easier management of ARDS due to its less invasive approach. As shown by recent studies, ECCO2R can be preferred in subjects with exacerbation of chronic obstructive pulmonary disease (COPD) who are unresponsive to non-invasive ventilation (NIV). One of the most important aspects of this can be stated as the reduced rate of endotracheal intubation.

Methods: Subjects that were admitted to intensive care unit between March 2014 to November 2015 due to hypercapnic respiratory failure were treated using ECCO2R.

Results: Over the study period, five patients received ECCO2R therapy. All subjects were managed with ECCO2R (Hemolung, A Lung Inc., Pittsburgh, USA) via a 15.5 FG percutaneously inserted cannula.

Conclusions: We observed that ECCO2R is a promising method in the management of patients having COPD and can be used to protect lungs in patients with ARDS.