Update on extracorporeal carbon dioxide removal: a comprehensive review on principles, indications, efficiency, and complications.

Perfusion
Thomas Staudinger

Abstract

Extracorporeal carbon dioxide removal means the removal of carbon dioxide from the blood across a gas exchange membrane without substantially improving oxygenation. Carbon dioxide removal is possible with substantially less extracorporeal blood flow than needed for oxygenation. Techniques for extracorporeal carbon dioxide removal include (1) pumpless arterio-venous circuits, (2) low-flow venovenous circuits based on the technology of continuous renal replacement therapy, and (3) venovenous circuits based on extracorporeal membrane oxygenation technology. Extracorporeal carbon dioxide removal has been shown to enable more protective ventilation in acute respiratory distress syndrome patients, even beyond the so-called "protective" level. Although experimental data suggest a benefit on ventilator induced lung injury, no hard clinical evidence with respect to improved outcome exists. In addition, extracorporeal carbon dioxide removal is a tool to avoid intubation and mechanical ventilation in patients with acute exacerbated chronic obstructive pulmonary disease failing non-invasive ventilation. This concept has been shown to be effective in 56-90% of patients. Extracorporeal carbon dioxide removal has also been used in ventilated ...Continue Reading

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Methods Mentioned

BETA
bronchoalveolar
lavage

Clinical Trials Mentioned

NCT02654327
NCT02252094
NCT02086084
NCT03255057
NCT02259335

Software Mentioned

ILA Activve
ECCO
Xtravent
ILA
Cardiohelp
GenMatch
Decap Smart ©
Decap
Decap Smart
Activve

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