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On the horizon: Extracorporeal carbon dioxide removal
Justin Hanks1, Steven Fox2, Omar Mehkri3
1Pulmonary and Critical Care Fellowship, Respiratory Institute, Cleveland Clinic, Cleveland, OH hanksj@ccf.org.
Cleveland Clinic Journal of Medicine
|December 1, 2022
Summary
Extracorporeal carbon dioxide removal (ECCO2R) is a mechanical method for treating hypercapnic respiratory failure. This review explores its mechanisms, benefits, and evidence in conditions like ARDS and COPD.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Cardiopulmonary Support
Background:
- Hypercapnic respiratory failure presents a significant clinical challenge.
- Current treatments for severe respiratory failure have limitations.
- Extracorporeal carbon dioxide removal (ECCO2R) offers a potential adjunctive therapy.
Purpose of the Study:
- To review the principles and mechanisms of ECCO2R.
- To discuss the physiological rationale for ECCO2R in respiratory failure.
- To summarize the current evidence supporting ECCO2R's clinical utility.
Main Methods:
- Literature review of studies investigating ECCO2R.
- Analysis of evidence in acute respiratory distress syndrome (ARDS).
- Examination of ECCO2R use in chronic obstructive pulmonary disease (COPD) exacerbations and status asthmaticus.
- Assessment of ECCO2R as a bridge to lung transplantation.
Main Results:
- ECCO2R facilitates the removal of carbon dioxide from the blood.
- Evidence suggests potential benefits in specific respiratory failure scenarios.
- ECCO2R is being explored for ARDS, COPD exacerbations, and as a bridge to transplant.
Conclusions:
- ECCO2R is a developing technology for managing hypercapnic respiratory failure.
- Further research is needed to establish optimal protocols and definitive clinical benefits.
- ECCO2R shows promise as a supportive therapy in critical respiratory conditions.
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