Extracorporeal carbon dioxide removal for acute respiratory failure: a review of potential indications, clinical practice and open research questions
Abstract Extracorporeal carbon dioxide removal ($ ECCO_{2} $R) is a form of extracorporeal life support (ECLS) largely aimed at removing carbon dioxide in patients with acute hypoxemic or acute hypercapnic respiratory failure, so as to minimize respiratory acidosis, allowing more lung protective ventilatory settings which should decrease ventilator-induced lung injury. $ ECCO_{2} $R is increasingly being used despite the lack of high-quality evidence, while complications associated with the technique remain an issue of concern. This review explains the physiological basis underlying the use of $ ECCO_{2} $R, reviews the evidence regarding indications and contraindications, patient management and complications, and addresses organizational and ethical considerations. The indications and the risk-to-benefit ratio of this technique should now be carefully evaluated using structured national or international registries and large randomized trials..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Intensive care medicine - 48(2022), 10 vom: 09. Aug., Seite 1308-1321 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Combes, Alain [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Acute respiratory failure |
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| Anmerkungen: |
© Springer-Verlag GmbH Germany, part of Springer Nature 2022 |
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| doi: |
10.1007/s00134-022-06796-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 520 | |a Abstract Extracorporeal carbon dioxide removal ($ ECCO_{2} $R) is a form of extracorporeal life support (ECLS) largely aimed at removing carbon dioxide in patients with acute hypoxemic or acute hypercapnic respiratory failure, so as to minimize respiratory acidosis, allowing more lung protective ventilatory settings which should decrease ventilator-induced lung injury. $ ECCO_{2} $R is increasingly being used despite the lack of high-quality evidence, while complications associated with the technique remain an issue of concern. This review explains the physiological basis underlying the use of $ ECCO_{2} $R, reviews the evidence regarding indications and contraindications, patient management and complications, and addresses organizational and ethical considerations. The indications and the risk-to-benefit ratio of this technique should now be carefully evaluated using structured national or international registries and large randomized trials. | ||
| 650 | 4 | |a Acute respiratory failure | |
| 650 | 4 | |a Extracorporeal carbon dioxide removal | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Outcome | |
| 700 | 1 | |a Brodie, Daniel |4 aut | |
| 700 | 1 | |a Aissaoui, Nadia |4 aut | |
| 700 | 1 | |a Bein, Thomas |4 aut | |
| 700 | 1 | |a Capellier, Gilles |4 aut | |
| 700 | 1 | |a Dalton, Heidi J. |4 aut | |
| 700 | 1 | |a Diehl, Jean-Luc |4 aut | |
| 700 | 1 | |a Kluge, Stefan |4 aut | |
| 700 | 1 | |a McAuley, Daniel F. |4 aut | |
| 700 | 1 | |a Schmidt, Matthieu |4 aut | |
| 700 | 1 | |a Slutsky, Arthur S. |4 aut | |
| 700 | 1 | |a Jaber, Samir |4 aut | |
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