[Experience with extracorporeal CO2 elimination]

The method of extracorporeal CO2-elimination (ECCO2-R) as described by L. Gattinoni [2] and Kolobow [5] is reported in ten patients with severe ARDS in whom conventional respirator therapy had failed. The method itself as well as important pulmonary function parameters, e.g. changes in gas exchange (Fig. 3), extravascular lung fluid (Fig. 6), and chest radiographs are explained. After 7-17 day treatment with the Life-Support System (LSS), seven patients were in satisfactory condition to allowing weaning from the ventilator (Responder). In three cases the lung mechanics and gas exchange were unchanged by the therapy with CO2 removal and high PEEP (Nonresponders). In the responders, oxygenation improved and the intrapulmonary shunt Qs/Qt (Fig. 4) decreased, followed by extravascular lung water and mean pulmonary arterial pressure (Fig. 5). Towards the end of the therapy we could find normalization of the compliance (Fig. 7) and chest X-rays, which may be interpreted as a cure. The results confirm our theory that ECCO2-R in combination with high PEEP and low-frequency ventilation seems to be an important method for future therapy of acute pulmonary failure.