Extracorporeal CO<sub>2</sub> removal (ECCO<sub>2</sub>R) in patients with stable COPD with chronic hypercapnia: a proof-of-concept study.

Pisani, Lara; Nava, Stefano; Desiderio, Emilia; Polverino, Mario; Tonetti, Tommaso; Ranieri, V Marco · Thorax · 2020

case_series · Level IV

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Abstract

Domiciliary non-invasive ventilation (NIV) effectively reduces arterial carbon dioxide pressure (PaCO<sub>2</sub>) in patients with stable hypercapnic chronic obstructive pulmonary disease, but a consistent percentage of them may remain hypercapnic. We hypothesised that extracorporeal CO<sub>2</sub> removal (ECCO<sub>2</sub>R) may lower their PaCO<sub>2</sub> Ten patients hypercapnic despite ≥6 months of NIV underwent a 24-hour trial of ECCO<sub>2</sub>R. Six patients completed the ECCO<sub>2</sub>R-trial with a PaCO<sub>2</sub> drop ranging between 23% and 47%. Time to return to baseline after interruption ranged 48-96 hours. In four patients, mechanical events led to ECCO<sub>2</sub>R premature interruption, despite a decreased in PaCO<sub>2</sub> This time window 'free' from hypercapnia might allow to propose the concept of 'CO<sub>2</sub> dialysis'.

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