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Extracorporeal carbon dioxide removal to "protect" the lung
S L Stirling1, J J Cordingley, D N Hunter
1Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London, UK.
Thorax
|July 30, 2009
Summary
Severe hypercapnic acidosis in patients on mechanical ventilation can be managed using arteriovenous extracorporeal carbon dioxide removal (AV-ECCO2R). This lung-protective ventilation strategy improved outcomes for two of three adult patients.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Extracorporeal Support Technologies
Background:
- Mechanical ventilation can cause lung injury when using injurious tidal volumes and airway pressures.
- Severe hypercapnic acidosis presents a significant challenge in managing patients requiring mechanical ventilation.
Observation:
- Three adult patients with severe hypercapnic acidosis were mechanically ventilated with high tidal volumes and airway pressures.
- These patients experienced persistent acidosis despite conventional ventilatory support.
Findings:
- Percutaneously inserted arteriovenous extracorporeal carbon dioxide removal (AV-ECCO2R) significantly reduced the need for ventilatory support.
- This allowed for the implementation of lung-protective ventilation strategies.
- Two out of three patients survived to hospital discharge.
Implications:
- AV-ECCO2R may be a valuable adjunctive therapy for facilitating lung-protective ventilation in severe respiratory failure.
- This approach can potentially improve patient outcomes and reduce ventilator-induced lung injury.
- Further research is warranted to establish the role of AV-ECCO2R in critical care settings.
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