Extracorporeal carbon dioxide removal (ECCO2R) is an efficient technique used in the management of hypercapnic respiratory failure. Its application in mechanically ventilated patients has been studied for over 30 years. We describe a case of severe, acute exacerbation of chronic obstructive pulmonary disease (AECOPD) unresponsive to non-invasive ventilation (NIV), where initiation of ECCO2R was used effectively to prevent endotracheal intubation.
HillJDO'BrienTGMurrayJJ. Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med1972;286:629–34.
2.
PeekGJMugfordMTiruvoipatiR. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): A multicentre randomised controlled trial. Lancet2009;374:1351–63.
3.
GattinoniLKolobowTTomlinsonT. Low-frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R): An experimental study. Anesth Analg1978;57:470–77.
4.
KolobowTGattinoniLTomlinsonTAPierceJE. Control of breathing using an extracorporeal membrane lung. Anesthesiol1977;46:138–41.
5.
TerragniPMaioloGRanieriVM. Role and potentials of low-flow CO2 removal system in mechanical ventilation. Curr Opin Crit Care2012;18:93–98.
6.
LightowlerJVWedzichaJAElliottMWRamFS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ2003;326:185–89.
7.
ChandraDStammJATaylorB. Outcomes of noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease in the United States, 1998–2008. Am J Respir Crit Care Med. 2012;185:152–59.
8.
BoninFSommerwerckULundLWTeschlerH. Avoidance of intubation during acute exacerbation of chronic obstructive pulmonary disease for a lung transplant candidate using extracorporeal carbon dioxide removal with the Hemolung. J Thorac Cardiovasc Surg2013;145:e43–44.
9.
OtsuTEzakiKNogamiT. [A case of exacerbation of chronic pulmonary disease successfully treated by extracorporeal lung assist with a membrane lung]. Nihon Kyobu Shikkan Gakkai Zasshi1986;24:1131–34. In Japanese.
10.
CardenasVJJrLynchJEAtesR. Venovenous carbon dioxide removal in chronic obstructive pulmonary disease: Experience in one patient. ASAIO J2009;55:420–22.
11.
KlugeSBrauneSAEngelM. Avoiding invasive mechanical ventilation by extracorporeal carbon dioxide removal in patients failing non-invasive ventilation. Intensive Care Med2012;38:1632–39.
12.
BurkiNKManiRKHerthFJ. A novel extracorporeal CO2 removal system: Results of a pilot study of hypercapnic respiratory failure in patients with COPD. Chest2013;143:678–86.
13.
ManiRKSchmidtWLundLWHerthFJ. Respiratory dialysis for avoidance of intubation in acute exacerbation of COPD. ASAIO J2013;59:675–78.
14.
MalliotakisPMouloudiEPrinianakisG. Influence of respiratory efforts on B2-agonist induced bronchodilation in mechanically ventilated COPD patients: A prospective clinical study. Respir Med2007;101:300–07.
