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07:52
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Practice and Perceptions on Extracorporeal Carbon Dioxide Removal in the Current Era: A Multinational Survey
Ravindranath Tiruvoipati1,2,3, Andrew Wang1, Matthew E Cove4
1Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia.
The Clinical Respiratory Journal
|June 16, 2026
Summary
Extracorporeal carbon dioxide removal (ECCO2R) shows varied clinical practices. Most clinicians surveyed believe an ECCO2R registry is needed to improve patient outcomes and resource use.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Medical Devices
Background:
- Extracorporeal carbon dioxide removal (ECCO2R) is a partial extracorporeal respiratory support method.
- It has the potential to mitigate lung injury in hypercapnic respiratory failure patients.
Purpose of the Study:
- To investigate current clinical practices and perceptions of ECCO2R.
- To assess the need for a dedicated ECCO2R registry.
Main Methods:
- A multinational survey was distributed to clinicians with ECCO2R experience.
- The survey targeted clinicians in Europe, Asia, Oceania, and the United States.
Main Results:
- Seventy responses (50% response rate) were analyzed.
- ECCO2R is primarily used for ARDS (46%), asthma (18%), and COPD (15%), often with low case volumes (0-10/year).
- Significant practice variations exist in initiation triggers, devices, access, blood flow, and anticoagulation monitoring. Key barriers include lack of evidence, cost, and complexity.
Conclusions:
- ECCO2R practices are highly variable, potentially impacting outcomes.
- A strong consensus (84%) supports the utility of an ECCO2R registry.
- Development of ECCO2R quality indicators is recommended for optimizing outcomes and resource utilization.
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