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Safety and Effectiveness of Carbon Dioxide Removal CO2RESET Device in Critically Ill Patients
Fabio Silvio Taccone1, Simone Rinaldi2, Filippo Annoni1
1Department of Intensive Care, Erasme Hospital, Lennik Road 808, 1070 Brussels, Belgium.
Background:
In this retrospective study, we report the effectiveness and safety of a dedicated extracorporeal carbon dioxide removal (ECCO2R) device in critically ill patients.
Methods:
Adult patients on mechanical ventilation due to acute respiratory distress syndrome (ARDS) or decompensated chronic obstructive pulmonary disease (dCOPD), who were treated with a dedicated ECCO2R device (CO2RESET, Eurosets, Medolla, Italy) in case of hypercapnic acidemia, were included. Repeated measurements of CO2 removal (VCO2) at baseline and 1, 12, and 24 h after the initiation of therapy were recorded.
Results:
Over a three-year period, 11 patients received ECCO2R (median age 60 [43-72] years) 3 (2-39) days after ICU admission; nine patients had ARDS and two had dCOPD. Median baseline pH and PaCO2 levels were 7.27 (7.12-7.33) and 65 (50-84) mmHg, respectively. With a median ECCO2R blood flow of 800 (500-800) mL/min and maximum gas flow of 6 (2-14) L/min, the VCO2 at 12 h after ECCO2R initiation was 157 (58-183) mL/min. Tidal volume, respiratory rate, and driving pressure were significantly reduced over time. Few side effects were reported.
Conclusions:
In this study, a dedicated ECCO2R device provided a high VCO2 with a favorable risk profile.
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