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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2022

09-08-2022 | ECMO | Narrative Review

Extracorporeal carbon dioxide removal for acute respiratory failure: a review of potential indications, clinical practice and open research questions

Authors: Alain Combes, Daniel Brodie, Nadia Aissaoui, Thomas Bein, Gilles Capellier, Heidi J. Dalton, Jean-Luc Diehl, Stefan Kluge, Daniel F. McAuley, Matthieu Schmidt, Arthur S. Slutsky, Samir Jaber

Published in: Intensive Care Medicine | Issue 10/2022

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Abstract

Extracorporeal carbon dioxide removal (ECCO2R) is a form of extracorporeal life support (ECLS) largely aimed at removing carbon dioxide in patients with acute hypoxemic or acute hypercapnic respiratory failure, so as to minimize respiratory acidosis, allowing more lung protective ventilatory settings which should decrease ventilator-induced lung injury. ECCO2R is increasingly being used despite the lack of high-quality evidence, while complications associated with the technique remain an issue of concern. This review explains the physiological basis underlying the use of ECCO2R, reviews the evidence regarding indications and contraindications, patient management and complications, and addresses organizational and ethical considerations. The indications and the risk-to-benefit ratio of this technique should now be carefully evaluated using structured national or international registries and large randomized trials.
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Metadata
Title
Extracorporeal carbon dioxide removal for acute respiratory failure: a review of potential indications, clinical practice and open research questions
Authors
Alain Combes
Daniel Brodie
Nadia Aissaoui
Thomas Bein
Gilles Capellier
Heidi J. Dalton
Jean-Luc Diehl
Stefan Kluge
Daniel F. McAuley
Matthieu Schmidt
Arthur S. Slutsky
Samir Jaber
Publication date
09-08-2022
Publisher
Springer Berlin Heidelberg
Keywords
ECMO
ECMO
Published in
Intensive Care Medicine / Issue 10/2022
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-022-06796-w

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