Extracorporeal carbon dioxide removal for lowering the risk of mechanical ventilation: research questions and clinical potential for the future

Andrew J. Boyle, Michael C. Sklar, James J. McNamee, Daniel Brodie, Arthur S. Slutsky, Laurent Brochard, Daniel F. McAuley, on behalf of the International ECMO Network (EMCONet)

Research output: Contribution to journalReview ArticleResearchpeer-review

22 Citations (Scopus)

Abstract

As a result of technical improvements, extracorporeal carbon dioxide removal (ECCO 2 R) now has the potential to play an important role in the management of adults with acute respiratory failure. There is growing interest in the use of ECCO 2 R for the management of both hypoxaemic and hypercapnic respiratory failure. However, evidence to support its use is scarce and several questions remain about the best way to implement this therapy, which can be associated with serious side-effects. This Review reflects the consensus opinion of an international group of clinician scientists with expertise in managing acute respiratory failure and in using ECCO 2 R therapies in this setting. We concisely review clinically relevant aspects of ECCO 2 R, and provide a series of recommendations for clinical practice and future research, covering topics that include the practicalities of ECCO 2 R delivery, indications for use, and service delivery.

Original languageEnglish
Pages (from-to)874-884
Number of pages11
JournalThe Lancet Respiratory Medicine
Volume6
Issue number11
DOIs
Publication statusPublished - 1 Nov 2018

Keywords

  • 6 ml/kg
  • avoid intubation
  • co-2 removal
  • noninvasive ventilation
  • membrane-oxygenation
  • co2 removal
  • lung-protective ventilation
  • obstructive pulmonary-disease
  • renal replacement therapy
  • respiratory-distress-syndrome

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