Extracorporeal CO2 removal for COPD exacerbations (VENT-AVOID trial)
Extracorporeal membrane oxygenation (ECMO) is a sometimes life-saving technology for acute respiratory or cardiac failure. ECMO remains primarily a rescue or bridging therapy, but as the technology has evolved, potential new applications continue to be tested.
One more recent iteration of ECMO is veno-venous extracorporeal CO2 removal (ECCO2R), in which a patient's blood is circulated outside their body through a filter which removes CO2 (without re-oxygenation), and returned back to their body through a dual-lumen catheter in the internal jugular vein. An external pump circulates the blood; anticoagulation prevents thrombosis in the circuit. ECCO2R has a niche use case in refractory status asthmaticus (in which CO2 is high, but oxygenation is adequate, so traditional ECMO is not needed), based on small case series.
ECCO2R has shown only theoretical therapeutic potential in other causes of respiratory failure, such as ARDS or chronic obstructive pulmonary exacerbations. In a 2015 revi…
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