The evolving role and practical application of extracorporeal carbon dioxide removal in critical care.

OBJECTIVE: Extracorporeal venovenous carbon dioxide removal (ECCO2R) is increasingly used to facilitate ultraprotective mechanical ventilation, or to prevent or avoid mechanical ventilation in selected patients. This review focuses on how extracorporeal devices clear CO2, their impact on native pulmonary physiology, and systemic gas exchange. Finally, we discuss the modifications to patient management required while on ECCO2R.