Extracorporeal CO2 removal (ECCO2R) in patients with stable COPD with chronic hypercapnia: a proof-of-concept study.
Lara PisaniStefano NavaEmilia DesiderioMario PolverinoTommaso TonettiV Marco RanieriPublished in: Thorax (2020)
Domiciliary non-invasive ventilation (NIV) effectively reduces arterial carbon dioxide pressure (PaCO2) in patients with stable hypercapnic chronic obstructive pulmonary disease, but a consistent percentage of them may remain hypercapnic. We hypothesised that extracorporeal CO2 removal (ECCO2R) may lower their PaCO2 Ten patients hypercapnic despite ≥6 months of NIV underwent a 24-hour trial of ECCO2R. Six patients completed the ECCO2R-trial with a PaCO2 drop ranging between 23% and 47%. Time to return to baseline after interruption ranged 48-96 hours. In four patients, mechanical events led to ECCO2R premature interruption, despite a decreased in PaCO2 This time window 'free' from hypercapnia might allow to propose the concept of 'CO2 dialysis'.
Keyphrases
- end stage renal disease
- chronic kidney disease
- chronic obstructive pulmonary disease
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- carbon dioxide
- randomized controlled trial
- blood pressure
- respiratory failure
- intensive care unit
- acute respiratory distress syndrome
- phase iii
- extracorporeal membrane oxygenation