Andrea Morelli1, Lorenzo Del Sorbo2,3, Antonio Pesenti4, V Marco Ranieri1, Eddy Fan5,6. 1. Department of Anesthesiology and Intensive Care, Policlinico Umberto 1, Sapienza University of Rome, Rome, Italy. 2. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 3. Extracorporeal Life Support Program, Toronto General Hospital, 585 University Avenue, PMB 11-123, Toronto, ON, M5G 2N2, Canada. 4. Fondazione IRCCS Ca' Granda, Ospendale Maggiore Policlinico and Department of Pathophysiology and Transplantation, Universita degli Studi di Milano, Milan, Italy. 5. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. eddy.fan@uhn.ca. 6. Extracorporeal Life Support Program, Toronto General Hospital, 585 University Avenue, PMB 11-123, Toronto, ON, M5G 2N2, Canada. eddy.fan@uhn.ca.
Abstract
PURPOSE: To review the available knowledge related to the use of ECCO2R as adjuvant strategy to mechanical ventilation (MV) in various clinical settings of acute respiratory failure (ARF). METHODS: Expert opinion and review of the literature. RESULTS: ECCO2R may be a promising adjuvant therapeutic strategy for the management of patients with severe exacerbations of COPD and for the achievement of protective or ultra-protective ventilation in patients with ARDS without life-threatening hypoxemia. Given the observational nature of most of the available clinical data and differences in technical features and performances of current devices, the balance of risks and benefits for or against ECCO2R in such patient populations remains unclear CONCLUSIONS: ECCO2R is currently an experimental technique rather than an accepted therapeutic strategy in ARF-its safety and efficacy require confirmation in clinical trials.
PURPOSE: To review the available knowledge related to the use of ECCO2R as adjuvant strategy to mechanical ventilation (MV) in various clinical settings of acute respiratory failure (ARF). METHODS: Expert opinion and review of the literature. RESULTS: ECCO2R may be a promising adjuvant therapeutic strategy for the management of patients with severe exacerbations of COPD and for the achievement of protective or ultra-protective ventilation in patients with ARDS without life-threatening hypoxemia. Given the observational nature of most of the available clinical data and differences in technical features and performances of current devices, the balance of risks and benefits for or against ECCO2R in such patient populations remains unclear CONCLUSIONS: ECCO2R is currently an experimental technique rather than an accepted therapeutic strategy in ARF-its safety and efficacy require confirmation in clinical trials.
Entities:
Keywords:
Adult; Artificial; Critical care; Extracorporeal CO2 removal; Intensive care units; Respiratory distress syndrome; Respiratory failure; Review; Ventilation
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