A novel extracorporeal CO2 removal system: results of a pilot study of hypercapnic respiratory failure in patients with COPD
Background - Hypercapnic respiratory failure in patients with COPD frequently requires mechanical ventilatory support. Extracorporeal CO2 removal (ECCO2R) techniques have not been systematically evaluated in these patients. - Methods - This is a pilot study of a novel ECCO2R device that utilizes a s...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2013
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| In: |
Chest
Year: 2015, Volume: 143, Issue: 3, Pages: 678-686 |
| ISSN: | 1931-3543 |
| DOI: | 10.1378/chest.12-0228 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1378/chest.12-0228 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0012369213601476 
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| Author Notes: | Nausherwan K. Burki, MD, PhD, FCCP; Raj Kumar Mani, MD, FCCP; Felix J.F. Herth, MD, FCCP; Werner Schmidt, MD; Helmut Teschler, MD; Frank Bonin, MD; Heinrich Becker, MD; Winfried J. Randerath, MD, FCCP; Sven Stieglitz, MD; Lars Hagmeyer, MD; Christina Priegnitz, MD; Michael Pfeifer, MD; Stefan H. Blaas, MD; Christian Putensen, MD, PhD; Nils Theuerkauf, MD; Michael Quintel, MD, PhD; and Onnen Moerer, MD |
| Summary: | Background - Hypercapnic respiratory failure in patients with COPD frequently requires mechanical ventilatory support. Extracorporeal CO2 removal (ECCO2R) techniques have not been systematically evaluated in these patients. - Methods - This is a pilot study of a novel ECCO2R device that utilizes a single venous catheter with high CO2 removal rates at low blood flows. Twenty hypercapnic patients with COPD received ECCO2R. Group 1 (n = 7) consisted of patients receiving noninvasive ventilation with a high likelihood of requiring invasive ventilation, group 2 (n = 2) consisted of patients who could not be weaned from noninvasive ventilation, and group 3 (n = 11) consisted of patients on invasive ventilation who had failed attempts to wean. - Results - The device was well tolerated, with complications and rates similar to those seen with central venous catheterization. Blood flow through the system was 430.5 ± 73.7 mL/min, and ECCO2R was 82.5 ± 15.6 mL/min and did not change significantly with time. Invasive ventilation was avoided in all patients in group 1 and both patients in group 2 were weaned; PaCO2 decreased significantly (P < .003) with application of the device from 78.9 ± 16.8 mm Hg to 65.9 ± 11.5 mm Hg. In group 3, three patients were weaned, while the level of invasive ventilatory support was reduced in three patients. One patient in group 3 died due to a retroperitoneal bleed following catheterization. - Conclusions - This single-catheter, low-flow ECCO2R system provided clinically useful levels of CO2 removal in these patients with COPD. The system appears to be a potentially valuable additional modality for the treatment of hypercapnic respiratory failure. - Trial registry - ClinicalTrials.gov; No.: NCT00987740 and 01021605; URL: www.clinicaltrials.gov |
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| Item Description: | Available online: 16 December 2015 Im Titel ist "2" nach "CO" tiefer gestellt Gesehen am 09.12.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1931-3543 |
| DOI: | 10.1378/chest.12-0228 |