Low-flow veno-venous extracorporeal CO2 removal: first clinical experience in lung transplant recipients

Low-flow extracorporeal CO2 removal devices are easy to setup and manage and may provide valuable ventilation support.

We employed a new device (ProLUNG) recently introduced into the clinical arsenal that exploits a simple hemoperfusion technique sustained by blood flows lower than 500 ml/min to remove CO2 from the venous blood. It was used as an adjunctive support to mechanical ventilation during and after four lung transplantations in our center.

Two patients with cystic fibrosis, one with pulmonary fibrosis, and one with emphysema were included. They underwent lung transplantation and presented hypercapnia and respiratory acidosis before, during, or after the surgical procedure. After 1 h of treatment with the ProLUNG circuit, all patients showed reduced CO2 levels and increased pH; these variables remained stable until the end of treatment.

Our data suggest that this new device is effective in removing CO2 and stabilizing the pH.